VI Autologous Bone Marrow Transplantation.pdf - Blog Science ...

sion in this arm. The evolution of WBC and PMN counts is remarkable since following
a first wave of neutrophils which occurred within the same time than the
complete recovery in arm A, a secondary aplasia developed, unresponsive to a
reintroduction of rh GM-CSF given subcutaneously. Prolonged
thrombocytopenia was observed in these patients, without the first wave observed
on the WBC and PMN curves. The history of these three patients was
uninspired when looking at parameters such as age, CBC parameters before
graft, history of prior marrow involvement, duration of previous chemotherapy,
prior radiotherapy which could have generated a marrow micro-environment
impairment. Opposite, the recovery from neutropenia and of thrombocytopenia
was peculiarly rapid and steady in arm A, whereas the number of cells grafted
were comparable in terms of nucleated cells and CFU-GM. The absence of difference
between the two groups of patients in terms of clinical parameters,
therapeutic procedures and number of CPU GM grafted suggests that PBSC collected
in arm B are more mature than in arm A. The number of 7-day CFU GM
assay does not reflect the number of pluripotent stem cells and is dependent of
the harvesting procedure.
CONCLUSION
Rh GM-CSF can mobilize PBSC for collection by cytapheresis. Nevertheless,
mobilization of pluripotent stem cells is dependent on the duration of stimulation
by growth factors. One must be cautious when comparing the number of
PBSC collected with various harvesting procedures evaluated by the 7-day CFU
GM assay.
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