Effects of progenitor cell dose and preleukapheresis use of human recombinant granulocyte colony-stimulating factor on the recovery of hematopoiesis after blood stem cell autografting in children.

The effects of progenitor cell dose on the recovery kinetics of hematopoiesis were assessed in 34 children who underwent marrow-ablative chemotherapy with peripheral blood stem cell (PBSC) autografting. One patient was not engrafted, probably because of a low dose of reinfused cells. In 25 patients whose PBSCs were harvested after intensive chemotherapy without recombinant granulocyte colony-stimulating factor (rG-CSF), we found a significant correlation between the colony-forming unit for granulocyte-macrophage (CFU-GM) infused per kilogram of the patient's body weight and the time to achieve an absolute granulocyte count (AGC) of > 0.5 x 10(9)/L (r = -0.817, p < 0.001) or a platelet count of > 50 x 10(9)/L (r = -0.703, p < 0.001). No association was seen between the number of burst-forming units for erythroid (BFU-E) infused and the speed of hematopoietic recovery. In the other 8 patients with low progenitor yields (< 1 x 10(5) CFU-GM/kg), in vivo induction of PBSC was attempted by administering rG-CSF (250 to 1000 micrograms/m2/day). Seven-day administration of rG-CSF before each leukapheresis increased the committed (CFU-GM: 37.7-fold; BFU-E: 45.6-fold) as well as multipotent (CFU-mix: 6.8-fold) progenitors. These collected cells were cryopreserved and then reinfused. Using a model for simulating hematopoietic recovery kinetics, we suggest that cells induced by rG-CSF could speed the recovery of granulocyte or platelet counts after PBSC autografting.