Comparison of rhG–CSF primed bone marrow and blood stem cell autografts: an analysis of engraftment in malignant lymphomas and solid tumours

Abstract: Many studies have documented faster engraftment after transplantation with peripheral blood stem cells (PBSC) compared to bone marrow (BM) stem cells. Most comparisons, however, have been between unprimed BM and primed PBSC. We have collected engraftment data on 39 patients from 4 Danish centres and compared G–CSF primed BM with G–CSF primed PBSC in malignant lymphoma and solid tumours. In the lymphoma group 6 BM transplants were compared with 8 PBSC transplants, whereas in the testicular cancer group 16 BM transplants were compared with 9 PBSC transplants. In the lymphoma group, the time to platelet engraftment (platelets >20times10⁹/l unsupported) was median 15 d in PBSC transplants and median 34 d in BM transplants (p=0.003). In the solid tumour patients the difference in time to platelet engraftment was 11 and 18 d in PBSC and BM transplants, respectively (p<0.0001). In an attempt to explain this difference we performed CD34⁺ subset analysis of BM and PBSC. This analysis revealed a higher content of lineage restricted cells (CD34⁺CD61⁺ and CD34⁺GlyA⁺) in PBSC compared to BM. In conclusion, G–CSF mobilized PBSC seems to result in faster engraftment than G–CSF primed BM, which could be explained by an increased number of lineage specific progenitors in PBSC compared to BM.