Peripheral blood progenitor cell transplantation: A single centre experience comparing two mobilisation regimens in 67 patients

Between June 1991 and January 1995 we performed 67 peripheral blood progenitor cell transplants (PBPCT). Ten patients (group 1) were mobilised with 7 gm/m² of cyclophosphamide followed by daily G-CSF injections (5 μg/kg, subcutaneously). When the white cell count reached 1 x 10⁹/l they were leukapheresed for 5 days. After stem cell infusion they received G-CSF (10 μg/kg/day) until the neutrophil count reached 1.5 x 10⁹/l. Fifty-six patients had PBPCs mobilised with 3 gm/m² of cyclophosphamide followed by daily subcutaneous G-CSF (5 μg/kg) and PBPCs were harvested on 2 consecutive days, when the white cell count rose to 4 x 10⁹/l. After stem cell infusion this group did not receive G-CSF, In 47 of the 56 patients (group 2) adequate MNC (≥ 4 x 10⁸/kg) and/or CFU-GM (≥ 10 x 10⁴/kg) were obtained. Insufficient MNC and/or CFU-GM were obtained in 10 patients. They were therefore transplanted using a combination of bone marrow and peripheral blood progenitor cells (group 3). Overall 64 patients successfully engrafted. Median days to neutrophils ≥ 0.5 x 10⁹/l were 9 (range 8-13), 12 (range 8-25) and 11 (range 9-16) and to platelets ≥ 50 x 10⁹/l were 11 (range 9-23), 13 (range 9-90) and 16 (range 13-99) in groups 1, 2 and 3 respectively. Patients in group 1 had a faster neutrophil recovery than patients in group 2 (P = 0.0002). The three patients who failed to engraft all received a combination of autologous peripheral blood and bone marrow cells.