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Mobilization of peripheral blood progenitor cells by sequential
administration of interleukin-3 and granulocyte-macrophage colony-
stimulating factor following polychemotherapy with etoposide, ifosfamide,
and cisplatin [see comments]
W Brugger, K Bross, J Frisch, P Dern, B Weber, R Mertelsmann and L Kanz
Albert-Ludwigs-University Medical Center, Department of Medicine I,
Freiburg, Germany.
We report on the requirements that have to be met to combine a standard-
dose chemotherapy regimen with broad antitumor activity with the
mobilization of peripheral blood hematopoietic progenitor cells. Thirty-
two cancer patients were given a 1-day course of chemotherapy consisting of
etoposide (VP16), ifosfamide, and cisplatin (VIP; n = 46 cycles), followed
by the combined sequential administration of recombinant human
interleukin-3 (rhIL-3) and recombinant human granulocyte-macrophage
colony-stimulating factor (rhGM-CSF). Control patients received GM-CSF
alone or were treated without cytokines. Maximum numbers of peripheral
blood progenitor cells (PBPC) were recruited on day 13 to 17 after
chemotherapy, with a median of 418 CD34+ cells/microL blood (range, 106 to
1,841) in IL-3/GM-CSF-treated patients, 426 CD34+/microL (range, 191 to
1,380) in GM-CSF-treated patients, and 46 CD34+/microL (range, 15 to 148)
in patients treated without cytokines. In parallel, there was an increase
in myeloid (10,490 colony-forming unit-granulocyte-macrophage [CFU-GM]/mL
blood; range, 1,000 to 23,400), as well as erythroid (10,660 burst-forming
unit-erythroid [BFU-E]/mL blood; range, 3,870 to 24,300) and multipotential
(840 CFU-granulocyte, erythrocyte, monocyte, megakaryocyte [GEMM]/mL blood;
range, 160 to 2,070) progenitor cells in IL-3 plus GM-CSF-treated patients.
In GM-CSF-treated patients, significantly less precursor cells of all
lineages were mobilized, particularly multipotential progenitors (400
CFU-GEMM/mL blood; range, 200 to 2,150). Only small numbers of CD34+ cells
and clonogenic progenitor cells could be recruited in intensively
pretreated patients. Our data document that after standard-dose
chemotherapy-induced bone marrow hypoplasia, IL-3 plus GM-CSF can be used
to recruit PBPC, which might shorten the hematopoietic recovery after
high-dose chemotherapy in chemosensitive lymphomas or solid tumors.
Volume 79,
Issue 5,
pp. 1193-1200,
03/01/1992
Copyright © 1992 by The American Society of Hematology
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