1996 Fiscal Year Final Research Report Summary
Basic and clinical research of allogeneic peripheral blood stem cell transplantation
| Project/Area Number |
06454348
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Hematology
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| Research Institution | Okayama University Medical School |
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Principal Investigator |
HARADA Mine Okayama University Medical School Professor, 医学部, 教授 (00019621)
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| Co-Investigator(Kenkyū-buntansha) |
TESHIMA Takanori Okayama Unversity Hospital Assistant, 医学部・附属病院, 助手 (40284096)
SHINAGAWA Katsuji Okayama Unversity Hospital Assistant, 医学部・附属病院, 助手 (00273988)
ISHIMARU Fumihiko Okayama Unversity Hospital Assistant, 医学部・附属病院, 助手 (50284097)
OHMOTO Eijiro Okayama Unversity Hospital Lecturer, 医学部・附属病院, 講師 (50213864)
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| Project Period (FY) |
1994 – 1996
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| Keywords | peripheral blood stem cell / G-CSF / allo-PBSCT / healthy donor / acute GVHD / chronic GVHD / VNTR analysis / allo-BMT |
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| Research Abstract |
Allogeneic peripheral blood stem cell transplantation (allo-PBSCT) as an alternative to allogeneic bone marrow transplantation (allo-BMT) has been under investigation, we studied the most suitable method of G-CSF administration and performed eight cases of primary allo-PBSCT for hematologic malignancies.
We conducted a comparative study of two different methods for administration of granulocyte colony-stimulating factor (G-CSF) on peripheral blood progenitor cell (PBSC) mobilization in 12 donors of allogeneic PBSC transplantation (PBSCT), because once a day administration may be comfortable for donors. Six donors received 5mug/kg of G-CSF twice a day for 5 days (Cohort 1), while other six donors received 10mug/kg of G-CSF once a day for 5 days (Cohort 2). Mean numbers of harvested CD34+ cells per apheresis were 4.4*10^6/kg in Cohort 1 and 5.1*10^6/kg in Cohort 2 : no significant difference was observed between two cohorts, suggesting primitive progenitors as well as lineage-committed pr
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ogenitors can be mobilized by G-CSF.Adverse effects including mild to moderate bone pain and thrombocytopenia were transient and well tolerated by all of the donors.
We performed allogeneic-PBSCT for nine patients with hematologic malignancies. The actually transplanted PBSC grafts contained 4.2-19.1*10^6 CD34+ cells/kg and GVHD prophylaxis was performed with cyclosporine A and short term methotrexate or methyl-prednisone. All patients were engrafted that was documented by VNTR analysis and hematopoietic recovery was rapid in 8 of 9 patients with >500 ANC/mul on days 9-17 and >20,000 platelets/mul (transfusion independent) on days 13-25. Six pts aliving in CR revealed A-GVHD in 3 cases (grade I&II) and C-GVHD in 2 cases (Extensive with quiescent & de novo type).
Our study indicates that allogeneic PBSC mobilized by G-CSF can provide rapid hematologic recovery without an increase or severity of A-GVHD despite a high T cell ratio in the grafts. These preliminary data suggest that allo-PBSCT may be used as an alternative to allo-BMT.More patients with longer follow-ups will be required to assess the frequency of C-GVHD and immunological reconstitution of allo-PBSCT. Less
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