Transplantation of enriched CD34-positive autologous marrow into breast cancer patients following high-dose chemotherapy: Influence of CD34-positive peripheral-blood progenitors and growth factors on engraftment

E. J. Shpall, R. B. Jones, S. I. Bearman, W. A. Franklin, P. G. Archer, T. Curiel, M. Bitter, H. N. Claman, S. M. Stemmer, M. Purdy, S. E. Myers, L. Hami, S. Tafts, S. Heimfeld, J. Hallagan, R. J. Berenson

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402 Scopus citations

Abstract

Purpose: To evaluate the capacity of enriched CD34-positive (CD34+) progenitor cells to reconstitute hematopoiesis in poor-prognosis breast cancer patients following administration of a high-dose alkylating agent chemotherapy regimen. Patients and Methods: Forty-four breast cancer patients received high-dose chemotherapy followed by autologous bone marrow support (ABMS) with CD34+ hematopoietic progenitor cells in five sequentially treated cohorts. Following infusion of CD34+ marrow, cohort no. 1 received no growth factor, cohort no. 2 received granulocyte colony-stimulating factor (G-CSF), and cohort no. 3 received granulocyte-macrophage colony-stimulating factor (GM-CSF). Cohort no. 4 received the CD34+ fractions of both marrow and peripheral-blood progenitor cells (PBPCs) plus G-CSF. Cohort no. 5 received only the CD34+ PBPCs plus G-CSF. Immunohistochemical staining for breast cancer was performed on all hematopoietic cell products before and after the positive selection procedure, to assess quantitatively the level of tumor-cell contamination. Results: Cohorts no. 1, 2, 3, 4, and 5 achieved a granulocyte count ≥ 500 x 109/L in a median of 23, 10, 16, 11, and 11 days, with a platelet count greater than 20,000 x 109/L documented in a median of 22, 23, 32, 12, and 10 days, respectively. The time to granulocyte reconstitution was significantly shorter for patients who received CD34+ PBPCs alone (cohort no. 5), or in combination with CD34+ marrow (cohort no. 4), when compared with those who received only the CD34+ marrow fraction (P < .01). From 1 to greater than 4 logs of breast cancer cell depletion were documented after CD34-selection, for patients in whom tumor was initially detected. Conclusion: CD34+ marrow and/or PBPCs provide reliable and timely hematopoietic reconstitution in breast cancer patients receiving high-dose chemotherapy. Contamination of both marrow and PBPCs with breast cancer cells was reduced using this positive selection technique.

Original languageEnglish (US)
Pages (from-to)28-36
Number of pages9
JournalJournal of Clinical Oncology
Volume12
Issue number1
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Shpall, E. J., Jones, R. B., Bearman, S. I., Franklin, W. A., Archer, P. G., Curiel, T., Bitter, M., Claman, H. N., Stemmer, S. M., Purdy, M., Myers, S. E., Hami, L., Tafts, S., Heimfeld, S., Hallagan, J., & Berenson, R. J. (1994). Transplantation of enriched CD34-positive autologous marrow into breast cancer patients following high-dose chemotherapy: Influence of CD34-positive peripheral-blood progenitors and growth factors on engraftment. Journal of Clinical Oncology, 12(1), 28-36. https://doi.org/10.1200/JCO.1994.12.1.28