Klin Onkol 1999; 12(3): 97-100.
Surnmary: Background: Following repeated courses of stem cell-toxic chemotherapy, mobilization of hematopoietic stem cells (HSC) appears to be decreased. For these reasons, HSC should be harvested prior to repeated HSC exposure to stem cell-toxic drugs. Design and Subjects: II patients with testicular cancer (3 in relapse and 8 with partial response) were included into analysis and according to mobilization protocol they were divided into 3 groups. HSC from 3 patients (pts) in group I (Gr.I.) were harvested after 3 cycles of cis-platin-based salvage chemotherapy (+ G-CSF), in 3 pts from Gr.lI. HSC harvesting was performed after cyclophosphamide (3g/m2) plus G-CSF, and for HSC mobilization in 5 pts from Gr.III., The first cycle of "salvage" chemotherapy (+ G-CSF) was used. Methods and Results: In pts from Gr.I., only a small number of CD34+ cells (1.63xI06 CD 34+cells/kg during 5 aphereses) was harvested and bone marrow harvesting (or remobilization) was necessary.In patients from Gr.II., successful harvestings were carried out (4.54xl06 CD34+cells /kg during 3 aphereses), but due to possible violation of standard salvage protocols we stopped this method. In pts from Gr.lII. 8.8x106 CD34+ cells /kg were harvested during 2 aphereses. Conclusions: Harvesting of a sufficient number of CD 34+ cells in pts with relapsed or partially responsive testicular tumors after the first cycle of disease-specific cis-platin-based salvage therapy, before HSC are comprornised because of stem cell-toxic chemotherapy, seems to be a practical approach.
