[A pilot study of G-CSF mobilized allogeneic bone marrow cells plus peripheral blood stem cells transplantation for malignant hematological diseases].

OBJECTIVE: To study the feasibility and clinical outcome of granulocyte-colony stimulating factor (G-CSF) mobilized allogeneic bone marrow (G-BM) plus G-CSF mobilized peripheral blood stem cells (G-PBSC) transplantation for malignant hematological disease.

METHODS: G-BM plus G-PBSC transplantation was conducted between siblings or between parent and child. G-CSF was injected hypodermically into 14 stem cell donors 5 micro g x kg(-1) x d(-1) for 4 approximately 6 days. On the 3rd day after beginning of G-CSF injection bone marrow blood was extracted from the posterior superior iliac spine of the donors; on the 4th day G-PBSCs were collected. The collected stem cells were transplanted immediately into the bodies of the 14 patients with hematological disease, including acute myelocytic leukemia, acute lymphocytic leukemia, multiple myeloma, myelodysplastic syndrome and severe aplastic anemia. The clinical outcomes, including the rate of engraftment, speed of engraftment, and the occurrence of acute graft versus host disease (aGVHD) and chronic graft versus host disease (cGVHD) were investigated.

RESULTS: All patients got endurable engraftment. The median time of recovery of neutrophil count to >or= 1 x 10(9)/L was 14 days (range 12 approximately 18 days). The median time to achieve a platelet count >or= 20 x 10(9)/L without transfusion was 13 days (range 11 approximately 65 days). Seven of the 14 patients developed aGVHD, 4 being in the grade I and 3 being in grade II. Three of the evaluable 9 patients developed extensive chronic GVHD. Two patients died of relapsed leukemia. One patient received secondary PBSCT from hte same donor because of ill engraftment and developed grade IV GVHD and died. The other 11 patients were still alive and event-free with a median follow-up duration of 455 days (range 84 approximately 715 days).

CONCLUSION: An effective treatment for malignant hematological disease, G-CSF mobilized allogeneic bone marrow plus peripheral blood stem cells transplantation provides rapid and sustained engraftment without increase in incidence of aGVHD and cGVHD.