TY - JOUR
T1 - Transplantation of enriched CD34-positive autologous marrow into breast cancer patients following high-dose chemotherapy
T2 - Influence of CD34-positive peripheral-blood progenitors and growth factors on engraftment
AU - Shpall, E. J.
AU - Jones, R. B.
AU - Bearman, S. I.
AU - Franklin, W. A.
AU - Archer, P. G.
AU - Curiel, T.
AU - Bitter, M.
AU - Claman, H. N.
AU - Stemmer, S. M.
AU - Purdy, M.
AU - Myers, S. E.
AU - Hami, L.
AU - Tafts, S.
AU - Heimfeld, S.
AU - Hallagan, J.
AU - Berenson, R. J.
PY - 1994/1/1
Y1 - 1994/1/1
N2 - 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.
AB - 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.
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U2 - 10.1200/JCO.1994.12.1.28
DO - 10.1200/JCO.1994.12.1.28
M3 - Article
C2 - 7505806
AN - SCOPUS:0028153538
VL - 12
SP - 28
EP - 36
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 1
ER -