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- Title
Peripheral blood progenitor cell collection after epirubicin, paclitaxel, and cisplatin combination chemotherapy using EPO-based cytokine regimens: a randomized comparison of G-CSF and sequential GM-/G-CSF.
- Authors
Perillo, Alessandro; Pierelli, Luca; Scambia, Giovanni; Serafini, Riccardo; Paladini, Umberto; Salerno, Maria Giovanna; Bonanno, Giuseppina; Fattorossi, Andrea; Leone, Giuseppe; Mancuso, Salvatore; Menichella, Giacomo; Perillo, A; Pierelli, L; Scambia, G; Serafini, R; Paladini, U; Salerno, M G; Bonanno, G; Fattorossi, A; Leone, G
- Abstract
<bold>Background: </bold>The peripheral blood progenitor cell (PBPC) mobilization capacity of EPO in association with either G-CSF or sequential GM-CSF/G-CSF was compared in a randomized fashion after epirubicin, paclitaxel, and cisplatin (ETP) chemotherapy.<bold>Study Design and Methods: </bold>Forty patients with stage IIIB, IIIC, or IV ovarian carcinoma were enrolled in this randomized comparison of mobilizing capacity and myelopoietic effects of G-CSF + EPO and GM-/G-CSF + EPO following the first ETP chemotherapy treatment. After ETP chemotherapy (Day 1), 20 patients received G-CSF 5 microg per kg per day from Day 2 to Day 13 and 20 patients received GM-CSF 5 microg per kg per day from Day 2 to Day 6 followed by G-CSF 5 microg per kg per day from Day 7 to Day 13. EPO (150 IU per kg) was given every other day from Day 2 to Day 13 to all patients in both arms of the study. Apheresis (two blood volumes) was performed during hematologic recovery.<bold>Results: </bold>The magnitude of CD34+ cell mobilization and the abrogation of patients' myelosuppression were comparable in both study arms; however, GM-/G-CSF + EPO patients had significantly higher CD34+ yields because of a higher CD34+ cell collection efficiency (57.5% for GM-/G-CSF + EPO and 46.3% for G-CSF + EPO patients; p = 0.0009). Identical doses of PBPCs mobilized by GM-/G-CSF + EPO and G-CSF + EPO drove comparable hematopoietic recovery after reinfusion in patients treated with identical high-dose chemotherapy.<bold>Conclusion: </bold>The sequential administration of GM-CSF and G-CSF in combination with EPO is feasible and improves the PBPC collection efficiency after platinum-based intensive polychemotherapy, associating high PBPC mobilization to high collection efficiency during apheresis.
- Subjects
PERIPHERAL circulation; HEMATOPOIETIC stem cells; BLOOD collection; OVARIAN tumors; ANTINEOPLASTIC agents; BIOTHERAPY; CISPLATIN; CLINICAL trials; COMPARATIVE studies; ERYTHROPOIETIN; GRANULOCYTE-colony stimulating factor; GRANULOCYTE-macrophage colony-stimulating factor; HEMATOPOIESIS; HEMATOPOIETIC stem cell transplantation; RESEARCH methodology; MEDICAL cooperation; PACLITAXEL; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; EPIRUBICIN; PHARMACODYNAMICS; TUMOR treatment
- Publication
Transfusion, 2001, Vol 41, Issue 5, p674
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1046/j.1537-2995.2001.41050674.x