Autologous blood stem-cell transplantation in patients with advanced Hodgkin's disease and prior radiation to the pelvic site

Journal Article · Fri Jun 01 00:00:00 EDT 1990 · Journal of Clinical Oncology; (USA)

OSTI ID:6695672

Koerbling, M H; Holle, R; Haas, R; Knauf, W; Doerken, B H; Ho, A D; Kuse, R; Pralle, H; Fliedner, T M; Hunstein, W ^[1]

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1. Heidelberg Univ. (West Germany)

Patients with relapsed Hodgkin's disease who respond to salvage therapy are successfully treated with cyclophosphamide, carmustine (BCNU), and etoposide (VP-16) (CBV) followed by autologus bone marrow transplantation (ABMT). Because of heavy pretreatment including radiation to the pelvic site, marrow harvest was not feasible in those patients. We therefore used blood-derived hemopoietic precursor cells as an alternative stem-cell source to rescue them after superdose chemotherapy. Hemopoietic precursor cells were mobilized into the peripheral blood either by chemotherapeutic induction of transient myelosuppression followed by an overshooting of blood stem-cell concentration, or by continuous intravenous (IV) granulocyte-macrophage colony-stimulating factor (GM-CSF) administration. The median time to reach 1,000 WBC per microliter, 500 polymorphonuclear cells (PMN) per microliter, or 20,000 platelets per microliter was 10, 20.5, and 38 days, respectively, for 50% of all patients. The platelet counts of two patients never dropped below 20,000/microL following autologous blood stem-cell transplantation (ABSCT), whereas two other patients had to be supported with platelets for 75 and 86 days posttransplant until a stable peripheral platelet count of 20,000/microL was attained. Among the 11 assessable patients, seven are in unmaintained complete remission (CR) at a median follow-up of 318 days. This is a first report on a series of ABSCTs in patients with advanced Hodgkin's disease proving that, despite prior damage to the marrow site, the circulating stem-cell pool is still a sufficient source of hemopoietic precursor cells for stem-cell rescue.

• OSTI ID: 6695672
• Journal Information: Journal of Clinical Oncology; (USA), Journal Name: Journal of Clinical Oncology; (USA) Vol. 8:6; ISSN JCOND; ISSN 0732-183X
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMAL CELLS
ANIMALS
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BLOOD PLATELETS
BODY
BODY AREAS
BODY FLUIDS
COMBINED THERAPY
CONNECTIVE TISSUE CELLS
DISEASES
GROWTH FACTORS
HODGKINS DISEASE
IMMUNE SYSTEM DISEASES
LYMPHOMAS
MACROPHAGES
MAMMALS
MAN
MATERIALS
MITOGENS
NEOPLASMS
ORGANIC COMPOUNDS
PATIENTS
PELVIS
PHAGOCYTES
PRIMATES
PROTEINS
SOMATIC CELLS
STEM CELLS
THERAPY
TRANSFUSIONS
TRANSPLANTS
VERTEBRATES