2004 年 30 巻 4 号 p. 280-287
We investigated a highly effective method for collecting a sufficient quantity of autologous peripheral stem cells from patients with multiple myeloma in a single attempt. Eight patients (5 males and 3 females, mean age : 56.5 years) underwent remission-induction chemotherapy (built around a VAD regimen), followed by mobilization chemotherapy using cyclophosphamide (CPA 2 g/m2 given for 2 days, 7 patients) or etoposide (VP-16, 500 mg/m2 for 3 days, one patient). When the leukocyte count dropped below 1, 000/μL, a granulocyte colony stimulating factor, lenograstim (7.1 ±2.9μg/kg/day), was administered for around 7 days. When the leukocyte count exceeded 104/μL, stem cells were collected by processing the blood in a fluid having a volume of three times that of circulating blood and using a COBE Spectra, a blood component separating device. The required number of hematopoietic stem cells (CD 34+ cells, over 2.0 × 106/kg) was obtained from 6 patients in a single operation (within 4 hours). From 5 of them, a sufficient quantity was obtained for tandem grafting. Through adequate drug monitoring from the standpoint of a pharmacist, no severe adverse effects that would have necessitated interrupting the cell collecting procedure occurred.