Collection of Peripheral Blood Hematopoietic Progenitors (PBHP) From Patients With Severe Aplastic Anemia (SAA) After Prolonged Administration of Granulocyte Colony-Stimulating Factor

• Published in: Blood Vol. 82; no. 5; pp. 1410 - 1414
• Main Authors: Bacigalupo, A., Piaggio, G., Podestá, M., Van Lint, M.T., Valbonesi, M., Lercari, G., Mori, P.G., Pasino, M., Franchini, E., Rivabella, L., Figari, O., Sogno, G., Raffo, M.R., Marmont, A.M.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.09.1993; The Americain Society of Hematology
• Subjects: Adolescent; Adult; Anemia, Aplastic - blood; Anemia, Aplastic - drug therapy; Anemias. Hemoglobinopathies; Antigens, CD - analysis; Antigens, Surface - analysis; Antigens, Surface - genetics; Antilymphocyte Serum - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Cyclosporine - therapeutic use; Diseases of red blood cells; Female; Granulocyte Colony-Stimulating Factor - administration & dosage; Hematologic and hematopoietic diseases; Hematopoietic Stem Cells - cytology; Hematopoietic Stem Cells - drug effects; Humans; Lymphocyte Depletion; Male; Medical sciences; Middle Aged; Phenotype; T-Lymphocytes - cytology; Time Factors; Human; Granulocyte colony stimulating factor; Treatment; Stem cell; Immunotherapy; Aplastic anemia; Hematopoietic cell; Hemopathy
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V82.5.1410.1410

The aim of this study was to test whether prolonged administration of granulocyte colony-stimulating factor (G-CSF) would allow the collection by leukapheresis of PBHP in patients with SAA. For this purpose, nine SAA patients, 7 to 46 years old, six of whom were enrolled at diagnosis of their disease and three after previous immunosuppression had failed, were treated with antilymphocyte globulin (ALG) (day 1 to 5), cyclosporin A (5 mg/kg/d orally) (day 6 to 90) and G-CSF 5 μg/kg/d (day 6 to 90). A total of 40 leukaphereses were performed, (range 2 to 7 per patient), between days +10 and +168 from G-CSF treatment. White blood cell count at the time of harvest ranged from 1.2 to 18.1 × 109/L. Results can be summarized as follows: the median number of cells collected per patient was 5.0 × 108/kg (range 2.6 to 18.7), the median number of CD34+ cells was 1.8 × 106/kg (range 0.27 to 3.8) and the median number of colony-forming units granulocyte-macrophage (CFU-GM) was 3.9 × 104/kg(range 0 to 39). Twenty leukaphereses performed between days + 33 and + 77 of G-CSF treatment grew granulocyte macrophages and erythroid colonies in vitro. No colony growth was obtained from 20 leukaphereses performed before day + 33 or after day + 80. In six patients the total number of CFU-GM recovered were in the range described for autologous peripheral blood stem cell grafts. (2.6 to 39 × 104/kg). In conclusion, this study suggests that circulating hematopoietic progenitors can be recovered after ALG priming and after at least 1 month of G-CSF treatment in a proportion of patients with SAA. Whether these cells will be suitable for autologous transplantation remains to be determined.