Autografting with peripheral blood CD34-positive cells following high-dose chemotherapy against breast cancer

  • OKUMURA Akira
    Department of Surgery Tokai University School of Medicine
  • TOKUDA Yutaka
    Department of Surgery, Tokai University School of Medicine Department of Cell Transplantation Center, Tokai University School of Medicine
  • OHTA Masatoshi
    Department of Surgery Tokai University School of Medicine
  • SUZUKI Yasuhiro
    Department of Surgery Tokai University School of Medicine
  • SAITO Yuki
    Department of Surgery Tokai University School of Medicine
  • KUGE Soichi
    Department of Surgery Tokai University School of Medicine
  • KUBOTA Mitsuhiro
    Department of Surgery Tokai University School of Medicine
  • MAKUUCHI Hiroyasu
    Department of Surgery Tokai University School of Medicine
  • TAJIMA Tomoo
    Department of Surgery Tokai University School of Medicine
  • NAKAMURA Yoshihiko
    Department of Cell Transplantation Center, Tokai University School of Medicine
  • HOTTA Tomomitsu
    Department of Cell Transplantation Center, Tokai University School of Medicine

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We report autologous CD34^+ cell transplantation performed in 3 cases of recurrent breast cancer. The hematological recovery in these cases was assessed by comparing with that in the previous cases of autologous hematopoietic stem cell transplantation performed with the same high-dose chemotherapy regimen. Patient 1 was a 32-year-old woman with pulmonary and skeletal metastases; patient 2, a 55-year-old woman with pulmonary metastases; and patient 3, a 48-year-old woman with hepatic metastases. On day 1, cyclophosphamide 1000mg/m^2 and epirubicin 130mg/m^2 were administered concurrently with granulocyte colony-stimulating factor, and peripheral blood stem cells were harvested on days 14-16. These stem cells were processed using anti-CD34 monoclonal antibody and an immunomagnetic bead device, Isolex 300i^<TM>. The high-dose chemotherapy regimen consisted of cyclophosphamide 2000mg/m^2/day, div, and thiotepa 200mg/m^2/day, div on day -5, -4, and -3. The harvested CD34^+ cells numbered 3.9±2.8×10^6/kg (range: 0.73-7.8/10^6/kg), and the CFU-GM, 8.3±5.6×10^5/kg (range: 1.2-15.1/10^5/kg). After the separation, the percent of CD34^+ cells was 81.9±11.6% (range: 65.8-96.4%), the CD34^+ cell yield, 71.8±30.2% (range: 46.0-129.6%), and the CFU-GM yield, 48.9±9.1% (range: 35.3-62.0%). At the time of transplantation, the number of nucleated cells was 0.55±0.31×10^5/kg, and that of CFU-GM, 31.2±17.8×10^5/kg. Comparison of the hematological recovery in these three cases with that in patients receiving an identical high-dose chemotherapy regimen revealed recovery rates significantly faster than in patients having bone marrow transplants, and approximately identical with that in peripheral blood stem cell transplantation cases. Abbreviations: CD34^+, CD34-positive; AHSCT, autologous hematopoietic stem cell transplantation; G-CSF, granulocyte colony-stimulating factor; PBSC, peripheral blood stem cells; HDC, high-dose chemotherapy

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