J Korean Med Sci.  2000 Feb;15(1):49-52. 10.3346/jkms.2000.15.1.49.

The possible cost effectiveness of peripheral blood stem cell mobilization with clophosphamide and the late addition of G-CSF

• Min YJ
• Kim SW
• Suh C
• Park J
• Kim HJ
• Kim JG
• Kim TW
• Lee JH
• Kim SB
• Lee KH
• Lee JS
• Kim WK
• Kim SH

• KMID: 1731233
• DOI: http://doi.org/10.3346/jkms.2000.15.1.49

Abstract

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p>0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.

Keyword

Stem Cells; CD34 Antigen; Hematopietic Stem Cell Transplantation; Granulocyte Colony-Stimulation Factor

MeSH Terms

Adult
Aged
Antigens, CD34/metabolism
Antigens, CD34/immunology
Antineoplastic Agents, Alkylating/therapeutic use*
Antineoplastic Agents, Alkylating/adverse effects
Breast Neoplasms/therapy
Comparative Study
Cost-Benefit Analysis
Cyclophosphamide/therapeutic use*
Cyclophosphamide/adverse effects
Drug Administration Schedule
Female
Graft Survival
Granulocyte Colony-Stimulating Factor/therapeutic use*
Granulocyte Colony-Stimulating Factor/adverse effects
Hematopoietic Stem Cell Mobilization/methods*
Hematopoietic Stem Cell Mobilization/economics*
Hematopoietic Stem Cell Mobilization/adverse effects
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells/metabolism
Hematopoietic Stem Cells/immunology
Human
Lymphoma, Non-Hodgkin/therapy
Male
Middle Age
Multiple Myeloma/therapy
Sarcoma, Ewing's/therapy