ABSTRACT. The aim of the study is to investigate the relation between the hematological recovery in patients after high dose chemotherapy and peripheral blood stem cell (PBSC) rescue and the number of reinfused previously collected stem cells assessed by the number of mononuclear cells (MNCs), CFU-GMs and CD34(+) cells in the harvest. Forty nine patients mobilized with different techniques were transplanted. Our data indicate that the number of reinfused MNCs and CFU-GMS has a statistical significant relationship with the duration of leukopenia and thrombocytopenia following high dose chemotherapy and PBSC rescue in patients with various malignancies.

Keywords: peripheral stem cells, transplantation, hematological recovery.

Reprint requests to: George Koumakis, M.D., BMT Unit, Hellenic Anticancer Institute, St. Savas Oncology Hospital, 171 Alexandras Ave, Athens-115 22 Greece.

ABSTRACT. In chronic granulomatous disease (CGD), diminished or absent neutrophil NADPH oxidase function leads to recurrent pyogenic infections and granuloma formation. In a recent randomized, placebo-controlled trial, short-term prophylactic use of recombinant human interferon gamma (rIFN-gamma 1b) reduced the risk of serious infection in CGD patients by 67%. The current study evaluated the safety and effectiveness of long-term rIFN-gamma therapy in CGD patients. Patients were treated three times weekly with rIFN-gamma and evaluated semiannually. Serious infections (requiring hospitalization and parenteral antibiotic therapy), adverse clinical events, and measures of growth and development were noted. Thirty patients were evaluated for 12 months. The total average duration of rIFN- gamma therapy was 2.5 years. Three patients developed a total of four serious infections (0.13 infections per patient year). This rate compares favorably with rates of 1.10 and 0.38 infections per patient year found in the placebo and rIFN-gamma groups, respectively, during a previous study. Common adverse events were fever (23%), diarrhea (13%), and flu-like illness (13%). No serious adverse event was attributable to rIFN-gamma therapy and no obvious effects on growth and development were observed. rIFN- gamma is a safe and effective adjunctive therapy for reducing the frequency and severity of serious infections in CGD patients.

Keywords: chronic granulomatous disease, interferon gamma,interferons, neutrophils, phagocytes, NADPH oxidase.

Reprint requests to: Lynn Bemiller, M.D., San Diego Blood Bank, 440 Upas St., San Diego, CA 92103 USA, phone (619) 296-6393, fax (619) 296-0126, e-mail: bldbnkr@aol.com.