Japanese Journal of Clinical Oncology 30:153-158 (2000)
© 2000 Foundation for Promotion of Cancer Research
A Successful and Simplified Filgrastim Primed Single Apheresis Method Without Large Volume Apheresis for Peripheral Blood Stem Cell Collection
Departments of 1Medical Oncology, 2Internal Medicine, 3Immunology, 4Radiation Oncology, and 5Haematology, Gülhane Military Medical Academy, Ankara, Turkey
Background: There is a tendency to use only one apheresis collection to reduce the morbidity and the cost of peripheral blood stem cell collection. We studied whether rapid and complete engraftment could be achieved by single apheresis by using only Filgrastim without large volume apheresis in previously treated patients.
Methods: Engraftment of single apheresis in 25 patients was compared with those of multiple apheresis in 26 patients; 52% of patients in the single apheresis group and 62% of patients in the multiple apheresis group were heavily pretreated. All patients received 10–15 µg/kg/day of Filgrastim starting on day 14 after 3–4 cycles of induction chemotherapy. Apheresis was performed using Cobe Spectra on day 4, 5 or 6 in the single apheresis group and every other day in the multiple apheresis group after day 3.
Results: The median collection volume was 250 ml (250–300 ml) in the single apheresis group and 750 ml (200–1500 ml) in the multiple apheresis group. The median CD34(+) cell number was not significantly different in the two groups (11.79 vs 9.38 x 106/kg). The median times to achieve leukocytes 
1 x 109/l and platelets 50 x 109/l counts were 10 days (8–21 days) and 15 days (9–38 days) in the single apheresis group vs 11 days (8–23 days) and 20 days (10–32 days) in the multiple apheresis group, respectively (p < 0.05). Antibiotic use was less in the single apheresis group than the multiple apheresis group (9 vs 12 days, p < 0.05).
Conclusion: Adequate numbers of peripheral stem cells were harvested by G-CSF in a single apheresis without large volume apheresis even in heavily pretreated patients. Rapid and complete engraftment occurred in all patients and it was faster in single than multiple apheresis.
+ For reprints and all correspondence: Fikret Arpaci, GATA Tibbi Onkoloji Bilim Dali, Etlik, 06018, Ankara, Turkey. E-mail: onkoloji@gata.edu.trAbbreviations: PBSC, peripheral blood stem cell; GF, growth factor; LVL, large volume leukapheresis; G-CSF, granulocte colony-stimulating factor; SA, single apheresis; MA, multiple apheresis; CAF, cyclophosphamide, doxorubicin, 5-fluorouracil; DHAP, dexamethasone, ara-C, cisplatin; VAD, vincristine, doxorubicin, dexamethasone; VIP, etoposide, ifosfamide, cisplatin; IPA, ifosfamide, cisplatin, doxorubicin; VACA, vincristine, doxorubicin, cyclophosphamide, dactinomycin; EP, etoposide, cisplatin; DMSO, dimethyl sulfoxide; MNC, mononuclear cell; HPCA-2, fluorescein isothiocyanate-conjugated anti-c antibody; ICE, ifosfamide, carboplatin, etoposide; BEAM, BCNU, etoposide, ara-C, melphalan; CyEAM, cyclophosphamide, etoposide, ara-C, melphalan; Cy, cyclophosphamide; TBI, total body irradiation; BECM, BCNU, etoposide, carboplatin, melphalan; RT, radiotherapy