Low Doses of GM-CSF (molgramostim) and G-CSF (filgrastim) After Cyclophosphamide (4 G/m2) Enhance the Peripheral Blood Progenitor Cell Harvest: Results of Two Randomized Studies Including 120 Patients

Overview

Journal Bone Marrow Transplant

Specialty General Surgery

Date 2006 Aug 3

PMID 16883311

Citations 2

Authors

P Quittet

P Ceballos

E Lopez

Z Y Lu

P Latry

C Becht

E Legouffe

N Fegueux

C Exbrayat

D Pouessel

V Rouille

J P Daures

B Klein

J F Rossi

Affiliations

Soon will be listed here.

Abstract

The use of a combination of G-CSF and GM-CSF versus G-CSF alone, after cyclophosphamide (4 g/m2) was compared in two randomized phase III studies, including 120 patients. In study A, 60 patients received 5 x 2 microg/kg/day of G-CSF and GM-CSF compared to 5 mug/kg/day of G-CSF. In study B, 60 patients received 2.5 x 2 microg/kg/day G-CSF and GM-CSF compared to G-CSF alone (5 microg/kg/day). With the aim to collect at least 5 x 10(6)/kg CD34 cells in a maximum of three large volume leukapherises (LK), 123 LK were performed in study A, showing a significantly higher number of patients reaching 10 x 10(6)/kg CD34 cells (21/29 in G+GM-CSF arm vs 11/27 in G-CSF arm, P=0.00006). In study B, 109 LK were performed, with similar results (10/27 vs 15/26, P=0.003). In both the study, the total harvest of CD34 cells/kg was twofold higher in G-CSF plus GM-CSF group (18.3 x 10(6) in study A and 15.85 x 10(6) in study B) than in G-CSF group (9 x 10(6) in study A and 8.1 x 10(6) in study B), a significant difference only seen in multiple myeloma, with no significant difference in terms of mobilized myeloma cells between G-CSF and GM-CSF groups.

Citing Articles

Evaluation of effectiveness of granulocyte-macrophage colony-stimulating factor therapy to cancer patients after chemotherapy: a meta-analysis.

Yu W, Hua Z Oncotarget. 2018; 9(46):28226-28239.

PMID: 29963274 PMC: 6021338. DOI: 10.18632/oncotarget.24890.

Genetic Engineering and Manufacturing of Hematopoietic Stem Cells.

Wang X, Riviere I Mol Ther Methods Clin Dev. 2017; 5:96-105.

PMID: 28480310 PMC: 5415326. DOI: 10.1016/j.omtm.2017.03.003.

References

Armitage S, Hargreaves R, Samson D, Brennan M, Kanfer E, Navarrete C . CD34 counts to predict the adequate collection of peripheral blood progenitor cells. Bone Marrow Transplant. 1997; 20(7):587-91. DOI: 10.1038/sj.bmt.1700938. View

Koumakis G, Vassilomanolakis M, Hatzichristou H, Barbounis V, Filis J, Papanastasiou K . Predictive factors affecting mobilization and peripheral blood stem cell (PBSC) collection using single apheresis (SA) for rescuing patients after high-dose chemotherapy (HD.CHE) in various malignancies. Bone Marrow Transplant. 1996; 18(6):1065-72. View

Spitzer G, Adkins D, Mathews M, Velasquez W, Bowers C, Dunphy F . Randomized comparison of G-CSF + GM-CSF vs G-CSF alone for mobilization of peripheral blood stem cells: effects on hematopoietic recovery after high-dose chemotherapy. Bone Marrow Transplant. 1998; 20(11):921-30. DOI: 10.1038/sj.bmt.1700999. View

Ketterer N, Salles G, Raba M, Espinouse D, Sonet A, Tremisi P . High CD34(+) cell counts decrease hematologic toxicity of autologous peripheral blood progenitor cell transplantation. Blood. 1998; 91(9):3148-55. View

Lyman S . Biologic effects and potential clinical applications of Flt3 ligand. Curr Opin Hematol. 1998; 5(3):192-6. DOI: 10.1097/00062752-199805000-00008. View

Hohaus S, Martin H, Wassmann B, Egerer G, Haus U, Farber L . Recombinant human granulocyte and granulocyte-macrophage colony-stimulating factor (G-CSF and GM-CSF) administered following cytotoxic chemotherapy have a similar ability to mobilize peripheral blood stem cells. Bone Marrow Transplant. 1998; 22(7):625-30. DOI: 10.1038/sj.bmt.1701422. View

Armitage J . Emerging applications of recombinant human granulocyte-macrophage colony-stimulating factor. Blood. 1998; 92(12):4491-508. View

Comenzo R, Sanchorawala V, Fisher C, Akpek G, Farhat M, CERDA S . Intermediate-dose intravenous melphalan and blood stem cells mobilized with sequential GM+G-CSF or G-CSF alone to treat AL (amyloid light chain) amyloidosis. Br J Haematol. 1999; 104(3):553-9. DOI: 10.1046/j.1365-2141.1999.01216.x. View

von Lindern M, Zauner W, Mellitzer G, Steinlein P, Fritsch G, Huber K . The glucocorticoid receptor cooperates with the erythropoietin receptor and c-Kit to enhance and sustain proliferation of erythroid progenitors in vitro. Blood. 1999; 94(2):550-9. View

10.

Waller C, von Lintig F, Daskalakis A, Musahl V, Lange W . Mobilization of peripheral blood progenitor cells in patients with breast cancer: a prospective randomized trial comparing rhG-CSF with the combination of rhG-CSF plus rhEpo after VIP-E chemotherapy. Bone Marrow Transplant. 1999; 24(1):19-24. DOI: 10.1038/sj.bmt.1701860. View

11.

Gratwohl A, Schmid O, Baldomero H, Horisberger B, Urbano-Ispizua A . Haematopoietic stem cell transplantation (HSCT) in Europe 2002. Changes in indication and impact of team density. A report of the EBMT activity survey. Bone Marrow Transplant. 2004; 34(10):855-75. DOI: 10.1038/sj.bmt.1704653. View

12.

Gorin N . Autologous stem cell transplantation in hematological malignancies. Springer Semin Immunopathol. 2004; 26(1-2):3-30. DOI: 10.1007/s00281-004-0172-4. View

13.

Harousseau J . Stem cell transplantation in multiple myeloma (0, 1, or 2). Curr Opin Oncol. 2005; 17(2):93-8. DOI: 10.1097/01.cco.0000152978.32304.37. View

14.

Liles W, Rodger E, Broxmeyer H, Dehner C, Badel K, Calandra G . Augmented mobilization and collection of CD34+ hematopoietic cells from normal human volunteers stimulated with granulocyte-colony-stimulating factor by single-dose administration of AMD3100, a CXCR4 antagonist. Transfusion. 2005; 45(3):295-300. DOI: 10.1111/j.1537-2995.2005.04222.x. View

15.

Schulman K, Birch R, Zhen B, Pania N, Weaver C . Effect of CD34(+) cell dose on resource utilization in patients after high-dose chemotherapy with peripheral-blood stem-cell support. J Clin Oncol. 1999; 17(4):1227. DOI: 10.1200/JCO.1999.17.4.1227. View

16.

Weaver C, Schulman K, Birch R, West W, Buckner C . Randomized trial of filgrastim, sargramostim, or sequential sargramostim and filgrastim after myelosuppressive chemotherapy for the harvesting of peripheral-blood stem cells. J Clin Oncol. 2000; 18(1):43-53. DOI: 10.1200/JCO.2000.18.1.43. View

17.

Costes V, Magen V, Legouffe E, Durand L, Baldet P, Rossi J . The Mi15 monoclonal antibody (anti-syndecan-1) is a reliable marker for quantifying plasma cells in paraffin-embedded bone marrow biopsy specimens. Hum Pathol. 2000; 30(12):1405-11. DOI: 10.1016/s0046-8177(99)90160-0. View

18.

Siena S, Schiavo R, Pedrazzoli P, Carlo-Stella C . Therapeutic relevance of CD34 cell dose in blood cell transplantation for cancer therapy. J Clin Oncol. 2000; 18(6):1360-77. DOI: 10.1200/JCO.2000.18.6.1360. View

19.

Charrier S, Chollet P, Bay J, Cure H, Kwiatkowski F, Portefaix G . Hematological recovery and peripheral blood progenitor cell mobilization after induction chemotherapy and GM-CSF plus G-CSF in breast cancer. Bone Marrow Transplant. 2000; 25(7):705-10. DOI: 10.1038/sj.bmt.1702205. View

20.

Koc O, Gerson S, Cooper B, Laughlin M, Meyerson H, Kutteh L . Randomized cross-over trial of progenitor-cell mobilization: high-dose cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) versus granulocyte-macrophage colony-stimulating factor plus G-CSF. J Clin Oncol. 2000; 18(9):1824-30. DOI: 10.1200/JCO.2000.18.9.1824. View