环磷酰胺联合重组人粒细胞集落刺激因子动员自体外周血干细胞

目的：观察环磷酰胺（ＣＴＸ）联合重组人粒细胞集落刺激因子对自体外周血干细胞（ＡＰＢＳＣ）的动员效果。方法：ＣＴＸ３．７±０．２ｇ／ｍ＾２第１天静滴，白细胞（ＷＢＣ）降至最低点时开始皮下注射ｒｈＧ－ＣＳＦ４．５±０．６μｇ．ｋｇ＾－１．ｄ＾－１，直至采集结束前一天，ＷＢＣ恢复至２．５×１０＾９／Ｌ以上时开始连日采集ＡＰＢＳＣ，采集用ＣＳ３０００ｐｌｕｓ或Ｃｏｂｅ血细胞分离机，当累计采集的单个核细胞（     

粒细胞集落刺激因子动员2型糖尿病患者外周血CD34~＋细胞的变化

背景：与正常人比较,2型糖尿病患者外周血CD34＋细胞含量已有明显下降。目的：分析2型糖尿病患者外周血动员后CD34＋细胞比例的变化。方法：将234例2型糖尿病患者按病程分为5组（〈1年,1～5年,〉5～〈10年,10～15年和≥15年）,予以粒细胞集落刺激因子动员。动员5d后,使用流式细胞仪检测外周血CD34＋细胞的含量,并利用Person简单相关及多元回归方法分析其与病程、血脂、尿酸的关系。结果与结论：糖尿病者外周血动员后CD34＋细胞水平与三酰甘油相关（r=-0.202,P=0.002）,与载脂蛋白B相关（r=-0.276,P=0.000）,与尿酸相关（r=-0.297,P=0.000）。经统计分析发现,糖尿病者外周血动员后CD34＋细胞数随糖尿病病程进展而逐渐下降。     

粒细胞集落刺激因子动员2型糖尿病患者外周血CD34+细胞的变化

背景:与正常人比较,2型糖尿病患者外周血CD34+细胞含量已有明显下降.目的:分析2型糖尿病患者外周血动员后CD34+细胞比例的变化.方法:将234例2型糖尿病患者按病程分为5组(<1年,1~5年,>5~<10年,10~15年和≥15年),予以粒细胞集落刺激因子动员.动员5 d后,使用流式细胞仪检测外周血CD34+细胞的含量,并利用Person简单相关及多元回归方法分析其与病程、血脂、尿酸的关系.结果与结论:糖尿病者外周血动员后CD34+细胞水平与三酰甘油相关(r=-0.202,P=0.002),与载脂蛋白B相关(r=-0.276,P=0.000),与尿酸相关(r=-0.297,P=0.000).经统计分析发现,糖尿病者外周血动员后CD34+细胞数随糖尿病病程进展而逐渐下降.     

粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合动员异基因造血干细胞移植

背景:目前FDA已批准应用于临床外周血造血干细胞移植的动员剂只有粒细胞集落刺激因子和粒-巨噬细胞集落刺激因子,其中粒细胞集落刺激因子单药应用是目前最主要的动员方案,但可引起供者骨骼肌肉酸痛、发热等不良反应。目的:回顾性分析以粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合应用为动员方案的异基因造血干细胞移植临床效果。方法:选择2004-01/2009-10河南省人民医院血液科以粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子联合应用为动员方案进行血缘全相合异基因造血干细胞移植51例,分析移植物成分、造血重建及移植物抗宿主病的发生率。结果与结论:动员96h后CD34+细胞占单个核细胞的比例为(0.97±0.13)%,CD34+CD38-细胞占CD34+细胞的比例为(37.49±4.03)%;移植后的快速造血重建与CD34+细胞、CD34+CD38-细胞输入量呈负相关。Ⅰ度、Ⅱ～Ⅳ度急性移植物抗宿主病的发生率分别为25.5%,15.7%;局限性、广泛性慢性移植物抗宿主病的发生率分别为39.2%,21.2%。提示在血缘全相合异基因造血干细胞移植中,粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合可有效实现干细胞动员,所获CD34+细胞完全可以满足快速造血重建的需要;输入较多的CD34+细胞、CD34+CD38-细胞可能利于快速造血重建。     

粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合动员异基因造血干细胞移植

背景：目前FDA已批准应用于临床外周血造血干细胞移植的动员剂只有粒细胞集落刺激因子和粒-巨噬细胞集落刺激因子,其中粒细胞集落刺激因子单药应用是目前最主要的动员方案,但可引起供者骨骼肌肉酸痛、发热等不良反应。目的：回顾性分析以粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合应用为动员方案的异基因造血干细胞移植临床效果。方法：选择2004-01/2009-10河南省人民医院血液科以粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子联合应用为动员方案进行血缘全相合异基因造血干细胞移植51例,分析移植物成分、造血重建及移植物抗宿主病的发生率。结果与结论：动员96h后CD34＋细胞占单个核细胞的比例为（0.97±0.13）%,CD34＋CD38-细胞占CD34＋细胞的比例为（37.49±4.03）%;移植后的快速造血重建与CD34＋细胞、CD34＋CD38-细胞输入量呈负相关。Ⅰ度、Ⅱ～Ⅳ度急性移植物抗宿主病的发生率分别为25.5%,15.7%;局限性、广泛性慢性移植物抗宿主病的发生率分别为39.2%,21.2%。提示在血缘全相合异基因造血干细胞移植中,粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合可有效实现干细胞动员,所获CD34＋细胞完全可以满足快速造血重建的需要;输入较多的CD34＋细胞、CD34＋CD38-细胞可能利于快速造血重建。     

阿糖胞苷、鬼臼乙叉甙联合粒细胞集落刺激因子动员自体外周血干细胞

目的:探讨Ara—C、VP16单用或联合用药加G—CSF动员自身外周血干细胞（APBSC）的效果。方法:5例每天单用Ara-C4g/m2,连用2d;2例每天单用VP—16 500mg/m2,连用4d;2例Ara-C与VP-16联合用药,每天剂量Ara-C1g/m2、Vp-16100mp/m2,连用5d。WBC降至10×109/L左右时加用惠尔血5μg·kg-1·d-1至采集结束。CD34+细胞/MNC>1％时用CS3000 plus血细胞分离机采集APBSC。结果:CD34+细胞/MNC持续超过1％的平均时间为≥5.1d,9例单次采集即获得CD34+26.6×106/kg,无严重不良反应。结论:Ara—C、VP16单用或联合用药加粒细胞集落刺激因子动员自身外周血干细胞的动员效率高,且安全,单次采集所获得造血干细胞的量可满足移植所需。     

粒细胞集落刺激因子动员骨髓干细胞治疗大鼠急性脑梗死

目的:探讨粒细胞集落刺激因子(G-CSF)对大鼠脑梗死的治疗效果。方法:采用线栓法制备大鼠脑梗死模型,于术后24 h进行神经病学评分分级,入选2分及以上的大鼠共20只,被随机分为给药组和对照组,每组10只。给药组腹腔注射G-CSF 10μg.kg-1.d-1;对照组腹腔内注射等量生理盐水均连用10 d。两组分别均于术前、术后10、20和27 d进行神经病学评分分级,于术前及术后10 d和27 d进行体重测定,并计算体重减轻率。术后27 d,将大鼠麻醉后处死取脑,进行氯化三苯四唑(TTC)染色,计算脑梗死容积与全脑容积比值。结果:术前两组体重比较差异无统计学意义(P>0.05);术后10 d和27 d,给药组大鼠体重减轻率显著小于对照组〔(-13.15±0.05)%比(-16.46±0.06)%,(9.72±0.10)%比(-8.97±0.05)%,P均<0.01〕;术后10 d,两组神经病学分级评分比较差异无统计学意义(P>0.05);术后20 d和27 d,给药组神经病学分级评分〔(1.30±0.48)分和(0.60±0.52)分〕显著低于对照组〔(2.20±0.92)分和(1.70±0.68)分,P<0.05和P<0.01〕;术后27 d,给药组脑梗死容积与全脑容积比值显著小于对照组〔(12.99±3.55)%比(22.87±2.12)%,P<0.01〕。结论:脑梗死急性期1~10 d给予G-CSF可以有效减轻大鼠缺血性脑梗死程度,减少脑梗死体积,促进大脑神经功能的恢复。     

粒细胞集落刺激因子在自体外周血干细胞移植治疗缺血性下肢血管病中的作用

目的:观察缺血性下肢血管病患者进行自体外周血干细胞移植时,应用粒细胞集落刺激因子后细胞成分的变化以及对自身身体状况的近期影响。方法:选取2004-11/2005-04解放军第四六三医院内分泌科收治的126例接受粒细胞集落刺激因子动员的缺血性下肢血管病患者,全部接受皮下注射粒细胞集落刺激因子5～12μg/(kg·d),连续4～5d。为防止血黏度增加引起心脑血管意外,在干细胞动员的同时应用低分子肝素钙5000u,皮下注射1次/d,连续4～5d。每天监测血细胞计数和凝血3项,同时采用流式细胞仪监测外周血中CD34+细胞数。观察并记录动员后及采集过程中、后出现的毒副反应。结果:按意向处理分析,实验纳入126例缺血性下肢血管病患者,全部进入结果分析。①全部患者动员过程中外周血象的变化:粒细胞集落刺激因子动员前白细胞数量为(5.35±1.64)×109L-1,动员第5天为(42.17±18.56)×109L-1,第6天为(44.23±17.47)×109L-1,动员后比动员前提高5～13倍(P<0.01);血红蛋白和血小板动员前后无明显变化。②全部患者动员后采集细胞悬液的情况:37例患者于动员第5天进行采集,单个核细胞数值和CD34+百分数分别为(432.68±89.36)×109L-1和(0.87±0.38)%;其余89例均于第6天进行采集,单个核细胞数值和CD34+百分数分别为(463.71±58.33)×109L-1和(0.90±0.35)%,两者基本相近(P>0.05)。③性别、年龄和体质量对单个核细胞数值和CD34+细胞百分数的影响:男性患者采集的单个核细胞数值高于女性患者(P<0.05),而单位体质量的CD34+细胞数值男女基本相近;以年龄55岁为界,大于55岁和小于55岁的患者差异显著(P<0.05);高体质量患者采集的单个核细胞数值高于低体质量患者(P<0.05),而单位体质量的CD34+细胞数值基本相似。④不良事件和副反应:主要的不良反应有骨痛、周身肌肉酸痛、乏力、头痛、失眠、食欲下降、恶心呕吐、低热,采集过程中可能出现口周、面部或四肢麻木,一般停药2～4d症状即可消失。结论:缺血性下肢血管病患者进行自体外周血干细胞移植时,粒细胞集落刺激因子作为有效动员剂,可有效动员单个核细胞和CD34+细胞,绝大部分患者能够耐受,但应使用一定剂量的抗凝剂预防不良反应的发生。     

国产与进口粒细胞集落刺激因子动员外周血造血干细胞的效果对照

为评估国产重组人粒细胞集落刺激因子在动员外周造血干细胞的效果,选择2001/2005收治的20例自体外周血造血干细胞移植患者,男11例,女9例,其中急性髓细胞白血病11例,急性淋巴细胞白血病5例,恶件淋巴瘤3例,多发性骨髓瘤1例.根据患者对约价承受能力分为2组:国产重组人粒细胞集落刺激因子动员组、进口重组人粒细胞集落刺激因子动员组,每组各10例,除急性髓细胞白血病采用大剂量阿糖胞昔动员外,其他均应用大剂量环磷酰胺动员,当白细胞降全低谷开始回升时加国产与进口重组人粒细胞集落刺激因子,白细胞升至5×109L-1以上开始采集外周血造血干细胞.所有患者均移植成功,两者在给药剂量、用约天数,采集干细胞质量、造血功能重建及药物毒副反应等方面差异均无显著性意义.     

粒细胞集落刺激因子动员外周血干细胞富集致肺损伤1例

背景:使用粒细胞集落刺激因子动员外周血干细胞后导致急性肺损伤仅有零星报道,机制尚不清楚.目的:探讨应用重组人粒细胞集落刺激因子动员外周血干细胞富集导致肺损伤的临床表现、机制.方法:报告1例粒细胞集落刺激因子动员外周血干细胞时导致咯血和影像学肺部结节状、片状阴影,并复习相关文献.结果与结论:粒细胞集落刺激因子可能会导致肺损伤,机制可能和中性粒细胞在肺部聚集、黏附、释放炎症递质有关.     

自体外周血CD34^＋细胞移植后巨细胞病毒感染的检测

背景:巨细胞病毒活动性感染,尤其是巨细胞病毒肺炎死亡率极高,并易合并细菌、真菌、原虫等感染,直接影响患者的长期存活.因此,寻找一种早期、敏感的巨细胞病毒检测方法显得特别重要.目的:探讨酶联免疫吸附法、免疫组织化学法及流式细胞仪检测在自体外周血造血干细胞移植后巨细胞病毒感染的早期诊断价值.设计、时间及地点:对比观察,病例来自2002/2005南方医科大学南方医院.对象:选择行自体外周血CD34+细胞移植的系统性红斑狼疮(16例)和天疱疮(3例)患者19例,其中男5例,女14例,年龄11～38岁.所有受试者均无糖尿病、哮喘、荨麻疹、湿疹、炎症性肠病和其他风湿病.方法:分别于移植前、移植后3,6,12,24个月进行外周血采集.主要观察指标:应用酶联免疫吸附法、免疫组织化学法及流式细胞仪检测19例接受自体外周血造血干细胞移植患者移植前、移植后3,6,12,24个月时的抗巨细胞病毒抗体及巨细胞病毒抗原.结果:19例患者均进入结果分析.血清学检测显示,全部标本抗巨细胞病毒IgG全部阳性,阳性率100%.抗巨细胞病毒IgM阳性3例,阳性率3.2%.免疫组织化学法检测巨细胞病毒抗原阳性14例,阳性率14.7%.流式细胞仪检测巨细胞病毒抗原阳性13例,阳性率13.7%.4种检测巨细胞病毒感染方法的阳性率存在显著差异(x2=261.929,P<0.01).结论:自体外周血造血干细胞移植后存在不同程度的巨细胞病毒感染,临床上开展流式细胞仪检测巨细胞病毒感染具有重要意义.     

First experience of autologous peripheral blood stem cell mobilization with biosimilar granulocyte colony- stimulating factor

Introduction  

Mobilization techniques for autologous peripheral blood stem cell (PBSC) collection include chemotherapy followed by hematopoietic growth factors, such as granulocyte colony-stimulating factor (G-CSF). Biosimilar versions of G-CSF are now available in Europe.     

Low-dose cyclophosphamide and granulocyte colony-stimulating factor are sufficient for peripheral blood stem cell mobilization in patients with multiple myeloma

Autologous stem cell transplantation (ASCT), supported by high-dose chemotherapy, is the prevalent option for multiple myeloma (MM) treatment in candidates suitable for transplantation. Although granulocyte colony-stimulating factor (G-CSF) supported cyclophosphamide (CY) is used as the pre-ASCT mobilization regimen, there is no consensus on the optimal dosage of CY. Thus, in this study, we examined the results of 47 MM patients, who underwent ASCT after mobilization with intermediate (ID) or low-dose (LD) CY treatment supported with G-CSF. As the mobilization regimen, we used ID (2.4 g/m²) of CY in 22 patients, and LD (1 g/m²) of CY in 25 patients. Adequate doses of CD34+ cells were collected in both groups. At the same time, febrile neutropenia was observed to be less common in patients in the LD-CY group. Additionaly 96% of patients in LD-CY group did not need to be hospitalized during the mobilization. In conclusion, we think that mobilization with LD-CY and G-CSF is advantageous since it results in a sufficient amount of stem cells in addition to being advantageous in terms of patient safety and cost.     

Autologous graft-versus-host disease after CD34+-purified autologous peripheral blood progenitor cell transplantation

Autologous graft-versus-host disease (GVHD) has been frequently reported after cyclosporine A (CsA) administration in the autologous setting. This complication is related to the disruption of self-tolerance mechanisms induced by CsA and may exert an antitumor effect. We report the spontaneous occurrence of autologous GVHD after CD34+-purified peripheral blood progenitor cell transplantation (PBPCT) in 5 out of 24 consecutive patients (20.8%). The syndrome was characterized by skin rash (5/5), pruritus (5/5), eosinophilia (5/5), and fever (2/5) occurring at a median of 37 days (range 22-60) after transplantation. Diagnosis was confirmed by skin biopsy in all patients. The syndrome was self-limiting, lasted a median of 25 days, and did not require treatment. The rate of autologous GVHD was high after CD34+-purified autologous PBPCT. In fact, no autologous GVHD was documented in an historical control of 100 consecutive patients submitted to unmanipulated PBPCT at the same institution. The manipulation of the graft by the purging procedure causes a profound T lymphocyte depletion, thus possibly perturbing the equilibrium between autoregulatory cells and autocytotoxic T cells. These observations add new interest to the antitumor efficacy of autologous GVHD and suggest new questions regarding the role of transplantation for autoimmune diseases.     

Tempo of hematologic recovery correlates with peripheral blood CD34+ cell level in patients undergoing stem cell mobilization

This study was undertaken to evaluate the relationship between the time to recovery of peripheral blood counts and CD34+ cells in the peripheral blood (PB) and apheresis collections of patients undergoing intensive chemotherapy followed by rhG-CSF. Twenty-three patients with a median age of 42 years (range 17–64) with malignancies underwent peripheral blood stem cell (PBSC) collection after cyclophosphamide (CY) 4 g/m² and etoposide (600 mg/m²) followed by rhG-CSF (10 μg/kg/day). The WBC, platelet counts, CD34+ cell counts per ml of PB, and CD34+ cells in apheresis products were followed in all patients. The relationship of the time to recovery of WBC >1,000/μl, >3,000/μl, >10,000/μl and platelets >20,000/μl and 50,000/μl was compared to the average daily CD34+ cells/ml in each patient using the Spearman Correlation test. The tempo of recovery of WBC and platelets were highly correlated with the average CD34+ cell count in blood. In order to derive some useful guidelines for the timing of apheresis, the patients were divided into two groups, early recover (ER) and late recover (LR) based on the median time (day 10) to reach WBC count greater than 1,000/μl. ER patients had an average daily PB CD34+ cell count of 9.04 × 10⁴/ml (range 0.44–17.5) and a median yield of CD34+ cells of 10.43 × 10⁶/kg (range 0.60–25.95) compared to LR patients, who had 1.87 × 10⁴/ml (range 0.32–5.44) in the PB (P = .001) and a yield 3.20 × 10⁶/kg CD34+ cells (range 0.037–9.39) (P = .001). Patients recovering their WBC to 1,000/ml within 10 days of completing this regimen may undergo PBSC collection and achieve minimum-target cell doses of >2.5 × 10⁶ CD34+ cells/kg—100% of the time. J. Clin. Apheresis 13:1–6, 1998. © 1998 Wiley-Liss, Inc.     

干细胞因子和粒细胞集落刺激因子联合动员小鼠外周血培养间充质干细胞的生物学特性

目的:粒细胞集落刺激因子和干细胞因子是血细胞生成过程中的两个重要细胞因子,由于两者协同作用通过细胞内信息传导改变或阻断干细胞的黏附分子表达,增加其数量并抑制细胞凋亡,改变骨髓间充质干细胞功能.联合利用两者动员小鼠外周血,培养间充质干细胞,并探讨在体外单层培养条件下向软骨细胞方向诱导的条件.方法:实验于2005-01/2006-03在河北医科大学第四医院科研中心河北省重点实验室完成.①实验材料:BALB/C小鼠,4～6周龄,雄性,体质量15～20 g,由河北医科大学实验动物中心提供.实验过程中对动物处置符合动物伦理学标准.②实验方法:利用密度梯度离心结合贴壁法,从经粒细胞集落刺激因子和干细胞因子动员后的BALB/C小鼠外周血分离培养间充质干细胞,取生长良好的细胞进行克隆形成能力检测,并应用流式细胞分析结合免疫组化方法鉴定.同时利用含有转化生长因子β1的高糖DMEM培养液诱导第3代间充质干细胞向软骨细胞分化,应用免疫组织化学方法检测Ⅱ型胶原表达情况.结果:①从外周血培养出的间充质干细胞与骨髓来源间充质干细胞表型相似,并可以向软骨细胞分化.流式细胞分析结果显示,细胞表达相关的抗原标记CD29和CD44,不表达造血细胞系的表面标志CD34和CD45.②免疫组织化学显示,第3代间充质干细胞Ⅱ型胶原、层黏连蛋白表达为阴性,波形蛋白为阳性.诱导后的间充质干细胞Ⅱ型胶原表达为阳性.③P1、P3、P5 3代细胞的克隆形成率不同,两两比较显示随着代数的增加,克隆形成率逐渐降低（21.32%,16.13%,9.63%,P<0.01）.结论:经干细胞因子和粒细胞集落刺激因子动员后的外周血中可以得到一定数量并且纯度较高的间充质干细胞,细胞在体外生长较活跃,并在特定培养液的诱导下可以向软骨细胞表型转化,但细胞传代次数较低.     

自体外周血干细胞动员中测定CD34^＋Thy—1＋细胞的意义

目的：确切评估动员后外周血干细胞（ＰＢＳＣ）水平的变化，及时指导临床选择最佳采血时机。方法：用流式细胞术测定化疗和粒细胞集落刺激因子（Ｇ－ＣＳＦ）联合动员时外周血ＣＤ３４＋Ｔｈｙ－１＋细胞含量的变化，同时用体外集落培养方法评价外周血祖细胞（ＰＢＰＣｓ）的克隆形成能力。结果：动员后循环血中ＣＤ３４＋Ｔｈｙ－１＋细胞、ＣＤ３４＋细胞和克隆形成细胞（ＣＦＣ）含量分别增高４８．６倍、５０．０倍和５３．１倍，高峰时间在化疗后第１２～１４天（注射Ｇ－ＣＳＦ的第６～８天）；外周血单个核细胞中ＣＤ３４＋Ｔｈｙ－１＋细胞、ＣＤ３４＋细胞的比例分别增高１３．８倍和１０．５倍；动员的早期阶段，ＣＤ３４＋细胞中Ｔｈｙ－１＋细胞比例最高。结论：联合应用化疗和Ｇ－ＣＳＦ对ＰＢＰＣｓ，尤其对早期干／祖细胞具有显著动员作用；用流式细胞术检测ＣＤ３４＋Ｔｈｙ－１＋细胞可及时指导临床准时采集ＰＢＳＣ。     

CD133+CD34+ and CD133+CD38+ blood progenitor cells as predictors of platelet engraftment in patients undergoing autologous peripheral blood stem cell transplantation

BackgroundHematopoietic stem cells (HSC) have been characterized by CD34+ expression and an adequate dose of CD34+ cells is associated with a complete engraftment. CD133 is a more specific marker of HSC.Materials and methodsWe studied the relationship between graft content of CD34+, CD133+, and CD38+ cells and trilineage engraftment after autologous stem cell transplantation in patients with different hematological disorders. Blood samples were obtained before and after mobilization with recombinant granulocyte-colony stimulating factor (G-CSF, 16 μg/kg), from apheresis collections, and after transplantation.ResultsCell subsets were quantified by flow cytometry, and the dose of each population infused was correlated with success of engraftment. G-CSF induced mobilization of CD133+CD38+ cells (12.6-fold) and CD133+CD34+ cells (14.7-fold). A correlation was observed between the infused dose of CD133+CD34+ and CD133+CD38+ cells and platelet engraftment.ConclusionCD133+CD34+ and CD133+CD38+ cells were mobilized with G-CSF and these cell subsets were correlated with platelet engraftment.     

Peripheral blood stem cell mobilization by chemotherapy with and without recombinant human granulocyte colony-stimulating factor.

Chemotherapy can serve as a stimulus for mobilizing hematopoietic progenitor cells to the peripheral blood for harvest via leukapheresis. Mobilized peripheral blood stem cells (PBSC) support rapid hematologic reconstitution after bone marrow aplasia induced by intensive myelosuppressive treatments. Our purpose was to develop effective mobilization regimens allowing collection of large quantities of PBSC. We administered high-dose cyclophosphamide (HDC, 4 gm/m2) or cyclophosphamide (4 gm/m2) plus etoposide (600 mg/m2) (HDCE) in a nonrandomized, sequential fashion to 94 patients with breast cancer, lymphoma, and other malignancies with collection of PBSC via leukapheresis during white blood cell (WBC) recovery from nadir counts. Each apheresis product was analyzed for total nucleated cell number, granulocyte-macrophage colony-forming units (CFU-GM) and CD34+ cells. Twenty-four additional patients with comparable pretreatment characteristics received HDCE plus recombinant human granulocyte colony-stimulating factor (HDCE+G) after chemotherapy through the end of apheresis. Patients receiving HDC were matched for age, sex, and disease but were more heavily pretreated. HDCE was superior to HDC in mean daily CFU-GM and CD34+ yield (p < 0.05), even when groups were adjusted for performance status and amount of prior therapy. HDCE+G led to 3.7 times more CFU-GM and 4.7 times more CD34+ cells than HDCE. Target PBSC yield, defined as > 20 x 10(4) CFU-GM/kg and >4 x 10(8) cells/kg, was achieved by 92% of HDCE+G patients after a median of three aphereses, 56% of HDCE patients after five aphereses, and 16% of HDC patients after six apheresis (p < 0.0001). Prior chemotherapy inversely correlated with the quantity of PBSC harvested regardless of regimen utilized. Our results demonstrate effective chemotherapy regimens for harvesting hematopoietic progenitors in a diverse patient population. HDCE+G produced the highest number of progenitors, suggesting that increasing dose intensity and adding rhG-CSF enhances mobilization. Correlation between cumulative CD34+ and CFU-GM allows real-time flow cytometric analysis of the number of aphereses required to harvest target numbers of PBSC.