A single prior course of BCNU-cisplatin chemotherapy has a significant deleterious effect on mobilization kinetics of otherwise untreated patients

摘要

Extensive prior treatment with cytotoxic agents isassociated with impaired mobilization of hematopoieticcells. To assess the effect of a single course of standarddosechemotherapy (CT), we compared the results offilgrastim-induced mobilization among two sequentialgroups of grade III–IV malignant glioma patientsincluded in a hematopoietic transplantation program.The first group (21 patients) had never been treated withCT until 2 days after surgery, when they received a courseof 100 mg/m2 BCNU (IV) and 100 mg intracarotidcisplatin for cytoreduction (not for mobilization). At 1month after this CT, they were mobilized with 12 lg/kgfilgrastim. The second group (22 patients) was mobilizedwith the same dose of filgrastim directly after the surgery,without having ever received any prior CT. The blood levelof CD34þ cells was significantly lower in the CT-treatedpatients, both on the fourth day of filgrastim (15 vs 36cells 106/l; P¼0.01) and on the fifth (25 vs58 cells 106/l; P¼0.003), as it was the number ofCD34þ cells collected per apheresis (1.3 vs 3.5 106/l;Po0.0005). The toxic effect of a single course of BCNUcisplatinCT led to significant impairment of thefilgrastim-induced mobilization response.Bone Marrow Transplantation advance online