Peripheral blood stem cell transplantation

Abstract

Recent data form the International Bone Marrow Transplantation Registry (IBM TR) show that 75 fatal diseases have been treated successfully with autologous and allogenic bone marrow transplantation (BMT). Peripheral blood stem cell as an alternative source of hematopoietic stem cell is now widely used to provide autologous bone marrow reconstitution after intensive chemoradiotherapy for hemalological malignancy and solid tumors. For allogenic transplantation, preliminary results showed PBSCs mobilized by rhG-CSF could also provide rapid hematological and immunogical reconstitution. In our hospital, sixteen patients with leukemia received allogenic PBSCT from HLA-identical sibling donors. 8 donors received 5 days of rhG-CSF(5ug/kg/ day)and the other 8 donors received 5 days of both rhGM-CSF{2.5ug/kg/day) and rhG-CSF(2.5ug/kg/day) as PBSCs mobilization. The conditioning regimen was cyclophosphamide (60mg/kg/day administered intravenously for 2 days), and fractional total body irradiation (4Gy × 3 =12 Gy, within 3 days. 5x 108 /kg total MNCs(2.78.3 × 108 /kg) or 5 × 106 /kg(1.0 - 8.0 xlO6 /kg)CE£cells from the allogenic donors were infused immediately after collections (by CS-3000 Plus) on day O.day+1 and day+2 (with day 0 designated as the first day of PBSCs infusion). Rapid WBC and platelet recovery was achieved. Median time to loan absolute neu-trophil count greater than 0.5 × 109/Lwas 16days(12-18 days). Median time to platelet greater than 20 × 109 /L was 13 days(12-14 days ). Engraftment evidences were documented by chromosome in 8 sexmismatched donor-recipient pairs and by analysis of variable number tandem repeat polymorphisms (HUMTH01[AATG]n) in 8 sex-matched pairs, 9 cases of sixteen patients developed acute GVHD. 4 patients died of severe acute GVHD. 6 patients of 12 survivors developed locai chronic GVHD. No leukemia relapse occurs in the follow-up of 4-13 months in all patients.