The Administration of 10 μg/kg Granulocyte Colony-Stimulating Factor (G-CSF) Alone Results in a Successful Peripheral Blood Stem Cell Collection When Previous Mobilization with Chemotherapy and Hematopoietic Growth Factor Failed

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Abstract
Some heavily pretreated cancer patients fail to mobilize enough peripheral blood stem cells (PBSC) after stimulation with chemotherapy and hematopoietic growth factors. For these patients the best way to obtain an adequate PBSC collection is unknown. Here we report 6 heavily pretreated cancer patients who failed to mobilize sufficient PBSC after stimulation with chemotherapy and G-CSF 5 μg/kg/day. In these cases, we used G-CSF 10 μg/kg/day alone for six days at least 3 weeks after the last chemotherapy. After three consecutive leukaphereses starting on day 5, five patients had adequate PBSC collections. With 6 days of G-CSF 10 μg/kg/day alone, 2.8 ± 106 (± 1) CD34+ cells/kg were collected. This was significantly higher than the number of CD34+ cells/kg collected after chemotherapy and G-CSF 5 μg/kg 0.3 ± 106 (± 0.1) [P = 0.05]. Four patients received high-dose chemotherapy with PBSC support. Hematologic recovery observed in these patients was as expected. In conclusion, G-CSF 10 μg/kg alone can mobilize progenitor cells into peripheral blood when previous mobilization with chemotherapy and G-CSF 5 μg/kg fails.