Portal de Periódicos da CAPES

Transplantation of highly purified CD34+Thy-1+ hematopoietic stem cells in patients with metastatic breast cancer

2000; Elsevier BV; Volume: 6; Issue: 3 Linguagem: Inglês

10.1016/s1083-8791(00)70008-5

1523-6536

Robert S. Negrin, K Atkinson, Tom Leemhuis, Elie G. Hanania, Christopher A. Juttner, Kathryn Tierney, Wendy Hu, Laura Johnston, Judith A. Shizuru, Keith Stockerl‐Goldstein, Karl G. Blume, Irving L. Weissman, Stephanie Bower, Roy Baynes, Roger Dansey, Chatchada Karanes, William P. Peters, Jared Klein,

Immunotherapy and Immune Responses

We re p o rt here the transplantation of extensively purified "mobilized" peripheral blood CD34 + T h y -1 + h e m a t o p o i e t i c stem cells from 22 patients with re c u rrent or metastatic breast cancer.Patients were mobilized with either high-dose granulocyte colony-stimulating factor (G-CSF) alone or cyclophosphamide plus G-CSF.Median purity of the stem cell p roduct at cry o p re s e rvation was 95.3% (range, 91.1%-98.3%),and viability was 98.6% (range, 96.5%-100%).After high-dose chemotherapy with carmustine, cisplatin, and cyclophosphamide, CD34 + T h y -1 + cells at a median dose of 11.3 × 1 0 5 per kilogram (range, 4.7-163 × 1 0 5 per kilogram) were infused.No infusion-related toxicity was observ e d .N e u t rophil re c o v e ry was prompt, with median absolute neutrophil count >500/L by day 10 (range, 8-15 days) and > 1 0 0 0 /L by day 11 (range, 8-17 days).Median platelet re c o v e ry (>20,000/L) was observed by day 14 (range, 9-42 days) and >50,000/L by day 17 (range, 11-49 days).Tumor cell depletion below the limits of detection of a sensitive immunoflu o rescence-based assay was accomplished in all patients who had detectable tumor cells in aphere s i s p roducts before processing.Although CD4 + T-cell reconstitution was slow, no unusual infections were observed.Neither early nor late graft failure was observed, and no patient re q u i red infusion of unmanipulated backup cells.At a median follow-up of approximately 1.4 years and a maximum follow-up of 2.5 years, 16 of the 22 patients remain alive, with 9 free of disease pro g ression, and have stable blood counts.In summary, highly purified CD34 + T h y -1 + cells used as the sole source of the hematopoietic graft result in rapid and sustained hematopoietic engraftment.