Ex vivo expanded unselected peripheral blood: progenitor cells reduce posttransplantation neutropenia, thrombocytopenia, and anemia in patients with breast cancer

RL Paquette, ST Dergham, E Karpf… - Blood, The Journal …, 2000 - ashpublications.org
RL Paquette, ST Dergham, E Karpf, HJ Wang, DJ Slamon, L Souza, JA Glaspy
Blood, The Journal of the American Society of Hematology, 2000ashpublications.org
The safety and efficacy of administering ex vivo expanded peripheral blood progenitor cells
(PBPC) to patients with breast cancer who undergo high-dose chemotherapy and PBPC
transplantation was investigated. Unselected PBPC were cultured in gas-permeable bags
containing 1-L serum-free media, granulocyte colony-stimulating factor, stem cell factor, and
pegylated megakaryocyte growth and development factor for 9 days. Cell dose cohorts were
assigned to have between 2 and 24× 109 PBPC cultured at 1, 2, or 3× 106 cells/mL. Twenty …
Abstract
The safety and efficacy of administering ex vivo expanded peripheral blood progenitor cells (PBPC) to patients with breast cancer who undergo high-dose chemotherapy and PBPC transplantation was investigated. Unselected PBPC were cultured in gas-permeable bags containing 1-L serum-free media, granulocyte colony-stimulating factor, stem cell factor, and pegylated megakaryocyte growth and development factor for 9 days. Cell dose cohorts were assigned to have between 2 and 24 × 109 PBPC cultured at 1, 2, or 3 × 106 cells/mL. Twenty-four patients received high-dose chemotherapy followed by infusion of the cultured PBPC and at least 5 × 106 CD34+ uncultured cryopreserved PBPC per kilogram. No toxicities resulted from infusions of the ex vivo expanded PBPC. The study patients had shorter times to neutrophil (P = .0001) and platelet (P = .01) recovery and fewer red cell transfusions (P = .02) than 48 historical controls who received the same conditioning regimen and posttransplantation care and at least 5 × 106CD34+ PBPC per kilogram. Improvements in all these endpoints were significantly correlated with the expanded cell dose. Nine of 24 (38%) patients recovered neutrophil counts above 500/μL by day 5 or 6 after transplantation, whereas none of the controls had neutrophil recovery before the eighth day. Seven (29%) patients had neutropenia for 3 or fewer days, and 9 (38%) patients did not experience neutropenic fevers or require broad-spectrum antibiotics. Therefore, ex vivo expanded PBPC are capable of ameliorating posttransplantation neutropenia, thrombocytopenia, and anemia in patients receiving high-dose chemotherapy.
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