Prognostic Factors of Peripheral Blood Stem Cell Mobilization with Cyclophosphamide and Filgrastim (r-metHuG-CSF): The CD34+ Cell Dose Positively Affects the Time to Hematopoietic Recovery and Supportive Requirements after High-Dose Chemotherapy

To prospectively analyze factors that influence peripheral blood stem cell (PBSC) collection and hematopoietic recovery after high-dose chemotherapy (HDC), 39 patients received cyclophosphamide 4 g/m2 and rHuG-CSF (Filgrastim) 5 μg/kg/day. Leukapheresis was started when CD34+ cells/mL were > 5 × 103. A minimum of 2 × 106 CD34+ cells/kg was collected. Median steady-state bone marrow CD34+ cell percentage was 0.8% (range, 0.1 to 6). Thirtytwo patients received HDC with autologous PBSC transplantation plus Filgrastim.A median of 2 (range, 0 to 6) leukapheresis per patient were performed and a median of 6.3 × 106 CD34+ cells/kg (range, 0 to 44.4) collected; four patients failed to mobilize CD34+ cells. The number of cycles of prior chemotherapy had an inverse correlation with the number CD34+ cells/kg collected (r =—0.38; p < 0.005). Patients with <7 cycles had a higher predictability for onset of leukapheresis than patients with 37 (93% versus 50%; p < 0.005). The four patients who failed to mobilize had rec...