High dose etoposide with granulocyte colony-stimulating factor for mobilization of peripheral blood progenitor cells: efficacy and toxicity at three dose levels

Title: High dose etoposide with granulocyte colony-stimulating factor for mobilization of peripheral blood progenitor cells: efficacy and toxicity at three dose levels
Authors: Kanfer, EJ
McGuigan, D
Samson, D
Abboudi, Z
Abrahamson, G
Apperley, JF
Chilcott, S
Craddock, C
Davis, J
MacDonald, C
Macdonald, D
Olavarria, E
Philpott, N
Rustin, GJS
Seckl, MJ
Sekhar, M
Stern, S
Newlands, ES
Item Type: Journal Article
Abstract: High-dose etoposide (2.0-2.4 g m(-2)) with granulocyte colony-stimulating factor (G-CSF) is an effective strategy to mobilize peripheral blood progenitor cells (PBPCs), although in some patients this is associated with significant toxicity. Sixty-three patients with malignancy were enrolled into this non-randomized sequential study. The majority (55/63, 87%) had received at least two prior regimens of chemotherapy, and seven patients had previously failed to mobilize following high-dose cyclophosphamide with G-CSF. Consecutive patient groups received etoposide at three dose levels [2.0 g m(-2) (n = 22), 1.8 g m(-2) (n = 20) and 1.6 g m(-2) (n = 21)] followed by daily G-CSF. Subsequent leukaphereses were assayed for CD34+ cell content, with a target total collection of 2.0 x 10(6) CD34+ cells kg(-1). Toxicity was assessed by the development of significant mucositis, the requirement for parenteral antibiotics or blood component support and rehospitalization incidence. Ten patients (16%) had less than the minimum target yield collected. Median collections in the three groups were 4.7 (2 g m(-2)), 5.7 (1.8 g m(-2)) and 6.5 (1.6 g m(-2)) x 10(6) CD34+ cells kg(-1). Five of the seven patients who had previously failed cyclophosphamide mobilization achieved more than the target yield. Rehospitalization incidence was significantly lower in patients receiving 1.6 g m(-2) etoposide than in those receiving 2.0 g m(-2) (P = 0.03). These data suggest that high-dose etoposide with G-CSF is an efficient mobilization regimen in the majority of heavily pretreated patients, including those who have previously failed on high-dose cyclophosphamide with G-CSF. An etoposide dose of 1.6 g m(-2) appears to be as effective as higher doses but less toxic.
Issue Date: 1-Oct-1998
Date of Acceptance: 1-Oct-1998
URI: http://hdl.handle.net/10044/1/61652
DOI: https://dx.doi.org/10.1038/bjc.1998.603
ISSN: 0007-0920
Publisher: Nature Publishing Group
Start Page: 928
End Page: 932
Journal / Book Title: BRITISH JOURNAL OF CANCER
Volume: 78
Copyright Statement: © 1998 Cancer Research Campaign.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
etoposide
progenitor cell
mobilization
BONE-MARROW TRANSPLANTATION
HEMATOPOIETIC STEM-CELLS
NON-HODGKINS-LYMPHOMA
BREAST-CANCER
G-CSF
CHEMOTHERAPY
YIELD
MALIGNANCIES
CYCLOPHOSPHAMIDE
INTENSIFICATION
Acute Disease
Adolescent
Adult
Aged
Antineoplastic Agents, Phytogenic
Antineoplastic Combined Chemotherapy Protocols
Choriocarcinoma
Etoposide
Female
Germinoma
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cell Mobilization
Hodgkin Disease
Humans
Leukemia
Lymphoma, Non-Hodgkin
Male
Middle Aged
Multiple Myeloma
Neoplasms
1112 Oncology And Carcinogenesis
Oncology & Carcinogenesis
Publication Status: Published
Online Publication Date: 1998-10-01
Appears in Collections:Division of Surgery
Division of Cancer
Department of Medicine
Faculty of Medicine



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons