• mobilization;
  • CD34+ cells ;
  • G-CSF;
  • malignant lymphoma;
  • peripheral stem cell support


  1. Top of page
  2. Abstract
  6. References

We compared retrospectively the efficacy of granulocyte colony stimulating factor (G-CSF) alone with chemotherapy plus G-CSF in mobilizing CD34-positive cells in patients with malignant lymphoma. 35 patients underwent peripheral blood stem cell (PBSC) collection following mobilization either with 24 μg/kg G-CSF for 4 consecutive days (n = 18) or Dexa-BEAM chemotherapy plus 5 μg/kg G-CSF (n = 17). High-dose G-CSF was well tolerated with only slight bone pain and/or myalgia. The Dexa-BEAM therapy required hospitalization with a median duration of 21 d. The median number of apheresis procedures in both groups was two (range two to four), resulting in a median of 5.3 and 5.1 × 106 CD34+ cells/kg. No patients in the G-CSF group, but one in the Dexa-BEAM group, failed to reach the target of collecting >2.0 × 106 CD34+ cells/kg. The number of CFU-GM (10.4 v 6.0 × 105/kg) and of BFU-E (10.6 v 4.5 × 105/kg; P = 0.04) was higher in the G-CSF group than in the Dexa-BEAM group. A subset analysis of CD34+ cells was performed in 16 patients showing a higher mean of Thy-1 (CD90w) coexpression in the G-CSF than in the Dexa-BEAM group (4.8 v 1.8%, P = 0.12). Additionally the percentage of CD34+/CD38 cells was higher in the G-CSF group (10.6% v 8.8%). However, these differences were not stastistically significant. The median time to leucocyte and platelet engraftment after high-dose chemotherapy was slightly shorter in the G-CSF than in the Dexa-BEAM group (9 v 10 and 12 v 13.5 d, respectively). These results demonstrate that high-dose G-CSF is as effective as Dexa-BEAM plus G-CSF in mobilizing peripheral blood stem cells and produces prompt engraftment. The major advantages of G-CSF mobilization were the safe outpatient self-application and the fixed-day apheresis.

High-dose chemo-radiotherapy followed by autologous blood stem cell support is increasingly used in the treatment of patients with high-risk or relapsed non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) ( Horning et al, 1994 ; Haioun et al, 1997 ; Kessinger et al, 1991 ; Haas et al, 1994 ). A randomized trial confirmed the superiority of high-dose chemotherapy followed by autologous bone marrow transplantion over standard salvage therapy for relapsing chemosensitive NHL ( Philip et al, 1995 ). Peripheral blood stem cell (PBSC) transplantion is now preferred to autologous bone marrow transplantation because of its more rapid engraftment of both neutrophils and platelets ( To et al, 1992 ; Schmitz et al, 1996 ). Mobilization of PBSC can be achieved with chemotherapy ( Schwartzberg et al, 1992 ) or cytokine alone ( Sheridan et al, 1992 ; Chao et al, 1993 ; Bensinger et al, 1994 ; Nademanee et al, 1994 ; Zeller et al, 1996 ) or with combination of both ( Gianni et al, 1989 ; Pettengell et al, 1993 ; Dreger et al, 1993 ; Jones et al, 1994 ; Haas et al, 1994 ; McQuaker et al, 1997 ). The dose of PBSC infused, as measured by CD34+ cell count, has been found to be an important predictor of engraftment regardless of disease or technique of mobilization ( Bensinger et al, 1995 ; Weaver et al, 1995 ). Therefore the optimal technique of mobilization still needs to be determined. The addition of cytokine to chemotherapy enables more PBSCs to be collected with fewer apheresis procedures than chemotherapy alone ( Schwartzberg et al, 1992 ). Dexa-BEAM has been reported to be an effective regimen for mobilizing PBSC in lymphoma patients ( Dreger et al, 1993 ). However, inadequate PBSCs collection was observed after chemotherapy plus G-CSF mobilization in some heavily pretreated patients ( Haas et al, 1994 ; Dreger et al, 1995 ). Additionally, these lymphoma patients had several problems with chemotherapy including neutropenic fever and non-haematological toxicity that could require hospitalization ( Dreger et al, 1995 ). A sufficient yield of PBSCs in lymphoma patients can be achieved with G-CSF (10 μg/kg) alone ( Nademanee et al, 1994 ). In a small study of seven patients with breast cancer, chemotherapy plus G-CSF resulted in a higher yield of PBSCs than low-dose G-CSF (300 μg) alone ( Möhle et al, 1994 ). We recently reported a dose–response effect on CD34+ cell mobilization with 10 and 24 μg/kg G-CSF in lymphoma patients ( Zeller et al, 1996 ). The current study was undertaken to compare the efficacy of high-dose G-CSF (24 μg/kg) versus Dexa-BEAM chemotherapy plus G-CSF (5 μg/kg) in mobilizing CD34+ cells, CD34+ cell subset and progenitor cells as well as on the haemopoietic engraftment in lymphoma patients.


  1. Top of page
  2. Abstract
  6. References


In the present retrospective study 35 patients with high-risk or relapsed malignant lymphoma were referred between 1995 and 1997 for peripheral blood stem cell collection before high-dose chemo-radiotherapy. 12 patients had HD and 23 had NHL (14 high-grade, nine low-grade). NHL was classified according the Kiel and REAL classifications ( Lennert & Feller, 1990; Harris et al, 1994 ). All patients provided written informed consent for Dexa-BEAM chemotherapy, for administration of G-CSF, collection of peripheral blood stem cells and for high-dose chemotherapy. There was no randomization between the mobilization procedures. Most of the Dexa-BEAM patients were referred for apheresis by other hospitals or were treated on lymphoma protocols. The median number of previous cycles of chemotherapy was 6.5 (range three to 24). The mobilization procedure was performed in 18 patients with high-dose G-CSF (24 μg/kg) alone, and 17 patients received Dexa-BEAM chemotherapy with G-CSF (5 μg/kg). Both groups were well balanced in terms of age, previous chemo- and radiotherapy and histology. The patient characteristics are listed in Table I. Dexa-BEAM chemotherapy required hospital admittance and included Dexamethasone 3 × 8 mg days 1–8, BCNU 60 mg/m2 day 2, etoposide 150 mg/m2 days 4–7, cytarabine 100 mg/m2 q12 h days 4–7, and melphalan 20 mg/m2 day 3. G-CSF (5 μg/kg, s.c.) was applied from day 8 until the last day of PBSC. Generally apheresis was started after the white blood count (WBC) exceeded 10 × 109/l as recommended ( Dreger et al, 1993 ).

Table 1. Table I. Characteristics of 35 lymphoma patients undergoing PBSC mobilizing therapy.Thumbnail image of

High-dose G-CSF (filgrastim; Amgen, Munich, Germany) was applied subcutaneously at a dose of 12 μg/kg twice daily with a time interval of 12 h. Apheresis was started on day 5, usually 2–3 h after the last injection. G-CSF application was continued until completion of leukapheresis ( Zeller et al, 1996 ). The minimum target of collection was >2.0 × 106 CD34+ cells/kg.

PBPC collection and cryopreservation

The collection of PBPC was performed with a Cobe Spectra using a 250 ml volume collection chamber. A total of 8–10 litres of blood per apheresis was processed at a flow rate of 50–70 ml/min; a mean volume of 250 ml was collected. This cell suspension was concentrated to a final volume of 50 ml and was mixed with 50 ml of minimal essential medium (MEM) containing 20% dimethylsulphoxide. The final 100 ml harvest product was transferred into freezer bags and frozen to −100°C with a computer-controlled cryopreservation device. The frozen cells were transferred into liquid nitrogen and stored at −196°C as described previously ( Hassan et al, 1996b ).

Progenitor cell assays

Unseparated MNC (1 × 105/ml) were grown in a 1.25% methylcellulose solution containing 10% lymphocyte-conditioned medium, 10% human plasma, 20% fetal calf serum, 9% Iscoves medium, 2-mercaptoethanol, and 3 U/ml erythropoietin. After a 14 d period of incubation in a humidified atmosphere with 5% CO2 and at 37°C, colony forming units granulocyte-macrophage (CFU-GM) and BFU-E were counted using an inverted microscope as described ( Hassan et al, 1996b ).

Immunofluorescence staining and flow cytometry

For determination of CD34-positive cells, 1 × 106 mononuclear cells (MNC), separated by Ficoll-Hypaque density gradient centrifugation, were incubated for 30 min at 4°C in darkness with phycoerythrin (PE)-conjugated monoclonal antibody anti-CD34 (HPCA-2, Becton Dickinson, Heidelberg, Germany). Analysis was performed on a FACScan flow cytometer (Becton Dickinson) with LYSIS II software (Becton Dickinson) according to the method published by Siena et al (1991 ). A minimum of 10 000 events were counted. To calculate the total CD34+ cells, the number of MNC per leukapheresis product was multiplied by the percentage of CD34+ cells. On thawed samples, subset analysis of CD34+ cells was performed on cells acquired in a CD34 fluorescence/SCC gate. The following antibodies were used: (PE)-conjugated monoclonal antibody anti-CD34 (HPCA-2, Becton Dickinson, Heidelberg, Germany), and fluorescein (FITC)-conjugated monoclonal antibodies anti-CD38 (DAKO, Hamburg, Germany), anti-CDw90 (Immunotech, Hamburg, Germany). Isotype-identical antibodies were used as controls: IgG1, IgG2a (FITC/PE-conjugated, Becton Dickinson, Heidelberg, Germany). A minimum of 100 events in the CD34+ cell gate were required.

High-dose chemotherapy

At time of analysis 10 patients from the Dexa-BEAM and 18 patients from the G-CSF group had been transplanted. High-dose chemotherapy consisted of total-body irradiation (TBI) and cyclophosphamide (Cy) (n = 2), TBI, Cy and etoposide (n = 5), BCNU, etoposide, melphalan and cytarabinoside (BEAM) (n = 15), busulphan, Cy, etoposide (n = 5) or busulphan, thiotepa and etoposide (n = 1) ( Table I). All protocols were approved by the local ethics committee.


Statistic analysis was performed using WinSTAT software (Kalmia Co. Inc., Cambridge, Mass.). For comparison of the two mobilizing regimens the independent t-test was used. The correlation analysis was calculated by Pearson test. A P-value of < 0.05 was considered significant.


  1. Top of page
  2. Abstract
  6. References


G-CSF administration was well tolerated with only slight bone pain in 61% of the patients. The Dexa-BEAM therapy required hospitalization for a median of 21 d (range 18–24). Most of the patients experienced fever during neutropenia, with a median duration of 3 d (range 0–5). In the Dexa-BEAM group the median days of i.v. antibiotic therapy was 6 d (range 0–7) and the median number of platelet transfusions was one (range one to two) ( Table II).

Table 2. Table II. Toxicities and supportive therapy.Thumbnail image of

PBSC collection

Stem cell collection was started after a median of 18 d (range 13–21) of Dexa-BEAM chemotherapy. The median number of WBC at time of first apheresis was 13.5 × 109/l (range 3.4–42 × 109/l). In the G-CSF group apheresis was started on day 5 of G-CSF application. In both groups a median of two apheresis procedures (range one to four) were performed, resulting in an overall number of 5.1 (range 0.3–24.8) and 5.3 (range 2.1–19) × 106 CD34+ cells/kg. In the first apheresis a median of 3.9 × 106 (range 0.2–24.8) and of 3.2 × 106 (range 1.0–13.1) CD34+ cells/kg could be harvested in the Dexa-BEAM and the G-CSF group, respectively. None in the G-CSF group, but one patient in the Dexa-BEAM group, failed to achieve the target collection of >2.0 × 106 CD34+ cells/kg. The overall number of CFU-GM was higher in the G-CSF than in the Dexa-BEAM group: 10.4 × 105 (range 1.6–128) versus 6.0 × 105 (range 0.8–90) but was not statistically significant. Significantly higher numbers of BFU-E were obtained in the G-CSF group: 10.6 × 105 (range 2.6–43) versus 4.5 × 105 (range 1.2–50), P = 0.04 ( Table III, Fig 1 ).

Table 3. Table III. Progenitor cell dose and colony forming units.Thumbnail image of

Figure 1. Fig 1. CD34+ cell yield and cloning efficiency after mobilization with G-CSF alone or Dexa-BEAM plus G-CSF. ns: not significant.

Download figure to PowerPoint

CD34+ cell subsets

Sixteen samples were evaluated for CD34 subset analysis (G-CSF group n = 7; Dexa-BEAM group n = 9). The mean percentage of CD34+/Thy-1 (CD90w)+ cells and of CD34+/CD38 cells were higher in the G-CSF- than in the Dexa-BEAM group (4.86% v 1.8% and 10.6% v 8.8%). However, the differences did not reach statistical significance.


Eighteen patients from the G-CSF group and 11 patients of the Dexa-BEAM group underwent high-dose chemo-radiotherapy. Reasons for not completing high-dose therapy in the Dexa-BEAM group were: early progress (n = 2), <1.0 × 106 CD34+ cells/kg harvested (n = 1) and too early for evaluation (n = 3). A prompt engraftment was seen in all patients: a slightly faster engaftment with leucocyte count >1.0 × 109/l was observed in the G-CSF group: 9 d (range 8–12) v 10 d (range 7–13). Additionally, a platelet count of >20 × 109/l was reached by the G-CSF group after a median of 12 d (range 9–150) and by the Dexa-BEAM group after a median of 13.5 d (range 11–26). These differences, however, did not reach statistical significance ( Table IV).

Table 4. Table IV. Engraftment with G-CSF or Dexa-BEAM + G-CSF mobilized progenitor cells. Thumbnail image of


  1. Top of page
  2. Abstract
  6. References

The rapid haemopoietic reconstitution after high-dose chemo-radiotherapy in patients with malignant lymphoma is due to the large number of progenitor cells collected by various stem cell mobilization regimens which may consist of chemotherapy, haemopoietic growth factors or both. The optimal mobilization regimen, however, in terms of safety, progenitor cell dose, engraftment and tumour cell contamination, remains to be determined. The addition of growth factors to chemotherapy has provided a better mobilization than chemotherapy alone and may ameliorate haematological toxicity ( Pettengell et al, 1993 ; Schwartzberg et al, 1992 ). Few studies have compared the efficacy of growth factors with different chemotherapy protocols. In patients with multiple myeloma, high-dose cyclophosphamide (7 g/m2) was more effective in mobilizing PBSC with less tumour cell contamination than intermediate dose (4 g/m2) ( Goldschmidt et al, 1996 ). The addition of etoposide improved mobilization with cyclophosphamide in myeloma patients, resulting in 92% of patients reaching the target of >5.0 × 106 CD34+ cells/kg in comparison to only 43% of the patients who received only cyclophosphamide ( Demirer et al, 1996 ). In lymphoma patients, combination chemotherapy consisting of etoposide, ifosfamide and epirubicin plus G-CSF resulted in a significantly higher amount of CD34+ cells than mobilization with cyclophosphamide (3–4 g/m2) plus G-CSF (8.62 × 106v 3.59 × 106) ( McQuaker et al, 1997 ).

G-CSF alone mobilizes sufficient progenitor cells in lymphoma patients to allow positive selection of CD34+ cells ( Mahéet al, 1996 ; Hassan et al, 1996a ). Recently, our group has shown a fourfold increase in CD34+ cell harvest by inreasing the G-CSF dose from 10 to 24 μg/kg in patients with malignant lymphoma and testicular cancer ( Zeller et al, 1996 ).

The present study has shown that in lymphoma patients high-dose G-CSF (24 μg/kg) is at least as effective as the commonly used Dexa-BEAM chemotherapy plus G-CSF (5 μg/kg). No patient in the G-CSF group but one in the Dexa-BEAM group failed to achieve the target collection of >2.0 × 106 CD34+ cells/kg. We found no difference in the CD34+ cell yield, but a higher number of CFU-GM (10.4 v 6.0 × 105/kg; n.s.) and of BFU-E (10.6 v 4.5 × 105/kg; P = 0.04) in the G-CSF group. Only one small study has compared chemotherapy plus G-CSF with G-CSF alone in mobilizing PBSCs in seven breast cancer patients. Mobilization with chemotherapy plus G-CSF resulted in a higher amount of CD34+ cells and of CFU-GM than with low-dose G-CSF alone ( Möhle et al, 1994 ). These differences might be explained by the different dose of G-CSF used in both studies. In our study 2 × 12 μg/kg G-CSF was used, whereas Möhle et al (1994 ) used only 300 μg G-CSF. The subset analysis of CD34+ cells in flow cytometry, however, showed similiar results, with higher of CD38 and lower Thy1 coexpression in the chemotherapy group, which might indicate more lineage commitment of the mobilized CD34+ cells ( Terstappen et al, 1991 ; Craig et al, 1993 ). The advantage of Dexa-BEAM plus G-CSF as mobilization regimen is that it can be carried out as an integrated part of the chemotherapy protocol. Furthermore, there might be an in-vivo purging effect of the graft, but tumour cell contamination has not been addressed in this study. In conclusion, stem cell mobilization G-CSF alone at an optimal dose was at least equal to Dexa-BEAM plus G-CSF in terms of CD34+ cell harvest, CFU-GM and BFU-E and ensures rapid engraftment. Thus, the advantages of mobilization with G-CSF alone are predictability of harvest time without chemotherapy-related toxicity and need of hospitalization.


  1. Top of page
  2. Abstract
  6. References
  • 1
    Bensinger, W.I., Appelbaum, F.R., Rowley, S., Storb, R., Sanders, J., Lilleby, K., Gooley, T., Demirer, T., Schiffmann, K., Weaver, C., Clift, R., Chauncey, T., Klarnet, J., Montgomery, P., Petersdorf, S., Weiden, P., Witherspoon, R., Buckner, C.D. (1995) Factors that influence collection and engraftment of autologous peripheral stem cells. Journal of Clinical Oncology, 13, 2547 2555.
  • 2
    Bensinger, W.I., Longin, K., Appelbaum, F., Rowley, S., Weaver, C., Lilleby, K., Gooley, T., Lynch, M., Higano, T., Klarnet, J., Chauncey, T., Storb, R., Buckner, C.D. (1994) Peripheral blood stem cells collected after recombinant granulocyte colony stimulating factor (rhG-CSF): an analysis of factors correlating with the tempo of engraftment after transplantation. British Journal of Haematology, 87, 825 831.
  • 3
    Chao, N.J., Schriber, J.R., Griomes, K., Long, G.D., Negrin, R.S., Raimondi, C.M., Horning, S.J., Brown, S.L., Miller, L., Blume, K.G. (1993) Granulocyte colony-stimulating factor mobilized peripheral blood progenitor cells accelerate granulocyte and platelet recovery after high-dose chemotherapy. Blood, 81, 2031 2035.
  • 4
    Craig, W., Kay, R., Cutler, R.L., Lansdorp, P.M. (1993) Expression of Thy-1 on human hematopoietic progenitor cells. Journal of Experimental Medicine, 177, 1331 1342.
  • 5
    Demirer, T., Buckner, C.D., Gooley, T., Appelbaum, F.R., Rowley, S., Chauncey, T., Lilleby, K., Storb, R., Bensinger, W.I. (1996) Factors influencing collection of peripheral blood stem cells in patients with multiple myeloma. Bone Marrow Transplantation, 17, 937 941.
  • 6
    Dreger, P., Klöss, M., Petersen, B., Haferlach, T., Löffler, H., Schmitz, N. (1995) Autologous progenitor cell transplantation: prior exposure to stem cell toxic drugs determines yield and engraftment of peripheral blood progenitor cells but not of bone marrow cells. Blood, 86, 3970 3978.
  • 7
    Dreger, P., Marquardt, P., Haferlach, T., Jabobs, S., Mulverstedt, T., Eckstein, V., Suttorp, M., Löffler, H., Müller-Ruchholtz, W., Schmitz, N. (1993) Effective mobilization of peripheral blood progenitor cells with Dexa-BEAM and G-CSF: timing of harvesting and composition of the leukapheresis product. British Journal of Cancer, 68, 950 957.
  • 8
    Gianni, A.M., Siena, S., Bregni, S., Stern, C., Tarella, C., Pileri, A., Bonnadonna, G. (1989) Granulocyte-macrophage colony-stimulating factor to harvest circulating haematopoietic stem cells for autotransplantation. Lancet, ii, 540 544.
  • 9
    Goldschmidt, H., Hegenbart, U., Haas, R., Hunstein, W. (1996) Mobilization of peripheral blood progenitor cells with high-dose cyclophosphamide (4 or 7 g/m2) and granulocyte stimulating factor in patients with multiple myeloma . Bone Marrow Transplantation, 17, 691 697.
  • 10
    Haas, R., Moos, M., Karcher, R., Möhle, R., Witt, B., Goldschmidt, H., Frühauf, S., Flentiji, M., Wannenmacher, M., Hunstein, W. (1994) Sequential high-dose therapy with peripheral blood progenitor cell support in low grade non-Hodgkin's lymphoma. Journal of Clinical Oncology, 12, 1685 1692.
  • 11
    Haioun, C., Lepage, E., Gisselbrecht, C., Basson, Y., Coiffier, B., Brice, P., Bosly, A., Duprice, B., Nouvel, C., Tilly, H., Lederlin, P., Biron, P., Briere, J., Goulard, P., Reyes, F. (1997) Benefit of autologous bone marrow transplantation over sequential chemotherapy in poor risk aggressive non Hodgkin's lymphoma: update results of the prospective study LNH87-2. Journal of Clinical Oncology, 15, 1131 1131.
  • 12
    Harris, N.L., Jaffe, E.S., Stein, H., Banks, P.M., Chan, J.K.C., Cleary, M.L. (1994) A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood, 84, 1361 1392.
  • 13
    Hassan, H.T., Krog, C., Stockschläder, M., Zeller, W., Krüger, W., Erttmann, R., Zander, A.R. (1997) Factors influencing the haematological recovery after allogenic bone marrow transplantation in leukaemia patients treated with methotrexate-containing GvHD prophylaxis: a single centre experience. Supportive Care Cancer, 57, 299 306.
  • 14
    Hassan, H.T., Zeller, W., Schleimer, B., Stockschläder, M., Krüger, W., Hoffknecht, M.M., Zander, A.R. (1996a) CD34 positive cell selection using CellPro Ceprate in 55G-CSF mobilised peripheral blood grafts collected for transplantation. Bone Marrow Transplantation, 17, (Suppl. 1), 245.
  • 15
    Hassan, H.T., Zeller, W., Stockschläder, M., Krüger, W, Hoffknecht, M.M., Zander, A.R. (1996) Comparison between bone marrow and G-CSF mobilized blood allograft undergoing clinical scale CD34 positive cell selection. Stem Cells, 14, 419 429.
  • 16
    Horning, S.J., Negrin, R.S., Chao, N.J., Long, G.D., Hoppe, R.T., Blume, K.G. (1994) Fractionated total body irradiation, etoposide, and cyclophosphamide plus autografting in Hodgkin's disease and non-Hodgkin's lymphoma. Journal of Clinical Oncology, 12, 2552 2558.
  • 17
    Jones, H.M., Jones, S.A., Watts, M.J., Khwaja, H., Mills, W., Fielding, J., Goldstone, A.H., Linch, D.C. (1994) Development of a simplified single apheresis approach for peripheral-blood progenitor cell transplantation in previously treated patients with lymphoma. Journal of Clinical Oncology, 12, 1693 1702.
  • 18
    Kessinger, M., Bierman, P.J., Vose, J.M., Armitage, J.O. (1991) High dose cyclophosphamide, carmustine and etoloside followed by autologous peripheral stem cell transplantation for patients with relapsed Hodgkin's disease. Blood, 77, 2322 2325.
  • 19
    Lennert, K. & Feller, A.C. (1990) Histopathologie der Non-Hodgkin Lymphome. Springer, Berlin.
  • 20
    Mahe, B., Milpied, N., Hermouet, S., Robillard, N., Moreau, P., Letortorec, S., Rapp, M.J., Bataille, R., Harousseau, J.L. (1996) G-CSF alone mobilizes sufficient peripheral blood CD34+ cells for positive selection in newly diagnosed patients with myeloma and lymphoma. British Journal of Haematology, 92, 263 268.
  • 21
    McQuaker, I.G., Haynes, A.P., Stainer, C., Anderson, S., Russell, N.H. (1997) Stem cell mobilization in resistant or relapsed lymphoma: superior yield of progenitor cells following a salvage regimen comprising ifosphamide, eoposide and epirubicin compared to intermediate-dose cyclophosphamide. British Journal of Haematology, 98, 228 233.
  • 22
    Möhle, R., Pfoersich, M., Fruehauf, S., Witt, B., Krämer, A., Haas, R. (1994) Filgrastim postchemotherapy mobilizes more CD34+ cells with a different antigenic profile compared with the use during steady-state hematopoiesis. Bone Marrow Transplantation, 14, 827 832.
  • 23
    Nademanee, A., Sniecinski, I., Schmidt, G.M., Dagis, A.C., O'Donnell, M.R., Snyder, D.S., Parker, P.M., Stein, A.S., Smith, E.P., Molina, R., Stepan, D.E., Somlo, G., Margolin, K.A., Wood, D., Niland, J.C., Forman, S.J. (1994) High-dose therapy followed by autologous peripheral blood stem cell transplantation for patients with Hodgkin's disease and non-Hodgkin' lymphoma using unprimed and granulocyte colony stimulating factor mobilized peripheral stem cells. Journal of Clinical Oncology, 12, 2176 2186.
  • 24
    Pettengell, R., Testa, N.G., Schwindell, R., Crowther, D., Dexter, T.M. (1993) Transplantation potential of hematopoietic cells released into circulation during routine chemotherapy for non-Hodgkin's lymphoma. Blood, 82, 2239 2248.
  • 25
    Philip, T., Guglielmi, C., Hagenbeek, A., Somers, R., Van Der Lelie, H., Bron, D., Sonneveld, P., Gisselbrecht, C., Cahn, J.Y., Harousseau, J.L., Coiffier, B., Biron, P., Mandelli, F., Chauvin, F. (1995) Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses in chemosensitive non-Hodgkin's lymphoma. New England Journal of Medicine, 333, 1540 1545.
  • 26
    Schmitz, N., Linch, D.C., Dreger, P., Goldstone, A.H., Booggerts, M.A., Ferrant, A., Demuynck, H.M.S., Zander, A.R., Borkett, K. (1996) A randomized trial of filgrastim-mobilised peripheral blood progenitor cell transplantation versus autologous bone marrow transplantation in lymphoma patients. Lancet, 347, 3563 3567.
  • 27
    Schwartzberg, L.S., Birch, R., Hazelton, B. (1992) Peripheral blood stem cell mobilization by chemotherapy with or without recombinant human granulocyte colony stimulating factor. Journal of Hematotherapy, 1, 317 327.
  • 28
    Sheridan, W.P., Begley, C.G., Juttner, C.A., Szer, J., To, L.B., Maher, D., McGrath, K.M., Morstyn, G., Fox, R.M. (1992) Effect of peripheral blood progenitor cells mobilised by filgrastim (G-CSF) on platelet recovery after high-dose chemotherapy. Lancet, 339, 640 644.
  • 29
    Siena, S., Bregni, M., Brando, B., Ravagnani, F., Bonnadonna, G., Ganni, A.M. (1991) Flow cytometry for clinical estimation of circulating hematopoietic progenitors for autologous transplantation in cancer patients. Blood, 77, 400 409.
  • 30
    Terstappen, L.W.M.M., Huang, S., Safford, M., Lansdord, P.M., Loken, M.R. (1991) Sequential generations of hematopoietic colonies derived from single non-lineage-committed CD34+ CD38 progenitor cells. Blood, 77, 1218 1227.
  • 31
    To, L.B., Roberts, M.M., Haylock, D.N., Dyson, P.G., Banford, A.L., Thorp, D., Ho, J.Q.K., Dart, G.W., Horvarth, N., Davy, M.L.J., Olweny, C.L.M., Abdi, E., Juttner, C.A. (1992) Comparison of hematological recovery times and supportive care requirements for autologous recovery phase peripheral blood stem cell transplants, autologous bone marrow transplants and allogenic bone marrow transplants. Bone Marrow Transplantation, 9, 277 284.
  • 32
    Weaver, C.H., Hazelton, B., Birsh, R., Palmer, P., Allen, C., Schwartzberg, L., West, W. (1995) An analysis of engraftement kinetics as a function of the CD34 content of peripheral blood progenitor cell collection in 692 patients after administration of myeloablative chemotherapy. Blood, 86, 3961 3969.
  • 33
    Zeller, W., Gutensohn, K., Stockschläder, M., Dierlamm, J., Kröger, N., Köhne, G., Hummel, K., Kabisch, H., Weh, H.J., Kühnl, P., Hossfled, D.K., Zander, A.R. (1996) Increase of mobilized CD34 positive peripheral blood progenitor cells in patients with Hodgkin's disease, non-Hodgkin's lymphoma, and cancer of the testis. Bone Marrow Transplantation, 17, 709 713.