CliniMACS CD34-selected cells to support multiple cycles of high-dose therapy.


BACKGROUND:Traditionally, following high-dose therapy (HDT), unmanipulated autologous PBPC are infused. Alternatively, purified CD34+ cells can now be obtained by immunomagnetic separation using the CliniMACS device. Limited data currently exist examining hemopoietic recovery with such cells. METHODS:Ten patients with advanced breast cancer had PBPC mobilized with docetaxel (100 mg/m2) and G-CSF (10 microg/kg per day), harvested and processed using the CliniMACS CD34-selection device and equally divided into three aliquots for cryopreservation. Unmanipulated 'back-up' cells were also collected on a separate day of the same mobilization, divided into three and cryopreserved. Patients subsequently received three cycles of HDT with cyclophosphamide (4 g/m2), thiotepa (300 mg/m2) and paclitaxel (175 mg/m2). The intent was for patients to receive CD34-selected cells to support each of the three cycles of HDT (i.e., 1/3 for each cycle). If, however, hemopoietic recovery was delayed after Cycle 1, 1/3 of the unmanipulated cells were infused following Cycle 2 and the remaining CD34-selected cells (2/3) were used to support Cycle 3. RESULTS:PBPC from 10 patients underwent CD34-selection with a resulting median purity of 93% (range: 76-98%) and yield of 62% (range: 16-93%). Of the 10 patients, only two were able to be supported with CD34-selected cells for all three cycles of HDT. The remaining eight patients required unmanipulated 'back-up' cells to support Cycle 2. Three patients also required infusion of 'back-up' unmanipulated cells because of persistent neutropenia (n = 1) or thrombocytopenia (n = 2) following cycles initially supported by CD34-selected cells. The median number of CD34-selected cells (x 10(6)/kg) infused per cycle was 1.5 (0.7-2.6) (n = 20) and unselected cells was 1.7 (1.4-2.8) (n = 10). Comparing hemopoietic recovery between cycles of HDT supported by CD34-selected (n = 20) and unmanipulated cells (n = 10) there was a significant slowing with the CD34-selected cells; time to ANC > 1.0 = 13 days versus 10 days, platelets > 20 = 17 days versus 13 days, > 50 = 25 versus 17 days (all P values < 0.001). There was no correlation between the dose of CD34-selected cells infused and neutrophil/platelet recovery. DISCUSSION:We have demonstrated that, although unmanipulated PBPC achieve rapid hemopoietic recovery (at modest CD34 doses of < or = 2.8 x 10(6)/kg), CliniMACS-selected CD34+ cells (in the doses utilized in this study of < or = 2.6 x 10(6)/kg) result in significantly prolonged recovery.






Prince HM,Wall D,Rischin D,Toner GC,Seymour JF,Blakey D,Haylock D,Simmons P,Wolf M,Januszewicz EH,Westerman D,Richardson G,Scarlett J,Briggs P





Has Abstract


2002-01-01 00:00:00














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    authors: Junker N,Andersen MH,Wenandy L,Dombernowsky SL,Kiss K,Sørensen CH,Therkildsen MH,Von Buchwald C,Andersen E,Straten PT,Svane IM

    更新日期:2011-08-01 00:00:00

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    更新日期:2009-01-01 00:00:00

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    更新日期:2015-11-01 00:00:00

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    更新日期:2002-01-01 00:00:00

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    更新日期:2013-11-01 00:00:00

  • Extracorporeal photopheresis as first-line strategy in the treatment of acute graft-versus-host disease after hematopoietic stem cell transplantation: A single-center experience.

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    authors: Sestili S,Eder S,Belhocine R,Dulery R,Battipaglia G,Brissot E,Mediavilla C,Banet A,van de Wyngaert Z,Paviglianiti A,Ledraa T,Bonin A,Mohty M,Malard F

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    更新日期:2006-01-01 00:00:00

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    authors: Galipeau J,Krampera M,Barrett J,Dazzi F,Deans RJ,DeBruijn J,Dominici M,Fibbe WE,Gee AP,Gimble JM,Hematti P,Koh MB,LeBlanc K,Martin I,McNiece IK,Mendicino M,Oh S,Ortiz L,Phinney DG,Planat V,Shi Y,Stroncek DF,Vi

    更新日期:2016-02-01 00:00:00

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    authors: Huang YZ,Cai JQ,Lv FJ,Xie HL,Yang ZM,Huang YC,Deng L

    更新日期:2013-03-01 00:00:00

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    更新日期:2018-01-01 00:00:00

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    authors: Bonilla C,Zurita M,Aguayo C,Rodríguez A,Vaquero J

    更新日期:2014-11-01 00:00:00

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    更新日期:2006-01-01 00:00:00

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    更新日期:2005-01-01 00:00:00

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    pub_type: 杂志文章,评审


    authors: de Wolf C,van de Bovenkamp M,Hoefnagel M

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    更新日期:2002-01-01 00:00:00

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    pub_type: 杂志文章,评审


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    更新日期:2017-12-01 00:00:00

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    pub_type: 杂志文章


    authors: Griesel C,Heuft HG,Herrmann D,Franke A,Ladas D,Stiehler N,Stucki A,Braun M,Wollert KC,Meyer GP,Drexler H,Hertenstein B,Ganser A,Rüdinger W,Arseniev L

    更新日期:2007-01-01 00:00:00

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    pub_type: 杂志文章


    authors: Kawai T,Katagiri W,Osugi M,Sugimura Y,Hibi H,Ueda M

    更新日期:2015-04-01 00:00:00

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    pub_type: 杂志文章,评审


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    更新日期:2005-01-01 00:00:00