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document
Recombinant human thrombopoietin augments mobilization of peripheral blood progenitor cells for autologous transplantation . This study assessed the ability of various schedules of recombinant human thrombopoietin ( rhTPO ) to enhance mobilization of peripheral blood progenitor cells ( PBPCs ) in 134 patients with cancer undergoing high-dose chemotherapy and autologous PBPC transplantation . Patients received the study drug on days 1 , 3 , and 5 before initiation of granulocyte colony-stimulating factor ( G-CSF ) 10 microg/kg/day on day 5 and pheresis starting on day 9 . Randomly assigned treatments on days 1 , 3 , and 5 were : group 1 ( n=27 ) placebo , placebo , rhTPO 1.5 microg/kg ; group 2 ( n=27 ) rhTPO 1.5 microg/kg , placebo , placebo ; groups 3 ( n=28 ) and 4 ( n=22 ) rhTPO 0.5 microg/kg on all 3 treatment days ; and group 5 ( n=30 ) placebo on all 3 treatment days . After high-dose chemotherapy and PBPC transplantation , groups 1 through 4 received rhTPO 1.5 microg/kg days 0 , +2 , +4 , and +6 with either G-CSF 5 microg/kg/day ( groups 1-3 ) or granulocyte-macrophage colony-stimulating factor 250 microg/m ( 2 ) /day ( group 4 ) . Group 5 received placebo plus G-CSF 5 microg/kg/day . The addition of rhTPO to G-CSF increased median CD34+ cell yield/pheresis in cohorts in which rhTPO was started before day 5 , with higher yields in groups 2 ( 2.67 x 10 ( 6 ) /kg ) and groups 3 and 4 ( 3.10 x 10 ( 6 ) /kg ) than in group 1 ( 1.86 x 10 ( 6 ) /kg ) or group 5 ( 1.65 x 10 ( 6 ) /kg ) ( P=.006 across groups ) . Comparing rhTPO to placebo , higher percentages of patients achieved the minimum yield of CD34+ > or =2 x 10 ( 6 ) /kg ( 92 % v 75 % ; P=.050 ) as well as the target yield of CD34+ > or =5 x 10 ( 6 ) /kg ( 73 % v 46 % ; P= .041 ) . rhTPO-treated patients required fewer phereses to achieve minimum ( P= .011 ) and target ( P= .015 ) CD34+ cell values . rhTPO given after transplantation did not speed platelet recovery . No neutralizing antibodies were observed . We conclude that rhTPO can safely enhance mobilization of PBPC , reduce the number of leukapheresis , and allow more patients to meet minimal cell yield requirements to receive high-dose chemotherapy with PBPC transplantation .
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Intervention_Pharmacological
Recombinant human thrombopoietin
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Intervention_Pharmacological
recombinant human thrombopoietin ( rhTPO )
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Intervention_Control
placebo , placebo
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Intervention_Pharmacological
rhTPO
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Intervention_Physical
high-dose chemotherapy and PBPC transplantation
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Intervention_Control
placebo
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Intervention_Pharmacological
rhTPO
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Intervention_Pharmacological
rhTPO
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Intervention_Pharmacological
rhTPO
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Intervention_Control
placebo
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Intervention_Physical
rhTPO-treated
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Intervention_Pharmacological
rhTPO
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Intervention_Pharmacological
rhTPO
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
PBPC transplantation
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Outcome_Physical
peripheral blood progenitor cells
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Outcome_Physical
median CD34+ cell yield/pheresis
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Outcome_Physical
minimum yield of CD34+
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Outcome_Physical
CD34+ cell values
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Outcome_Physical
platelet recovery
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Outcome_Physical
PBPC
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Outcome_Physical
leukapheresis
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Participant_Condition
autologous transplantation .
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Participant_Sample-size
134
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Participant_Condition
cancer