title: Efficacy of epirubicin/paclitaxel combination in mobilizing large amounts of hematopoietic progenitor cells in patients with metastatic breast cancer showing optimal response to the same chemotherapy regimen.
abstract: OBJECTIVE
  Based on our preliminary experience, we have further evaluated the capacity of the paclitaxel/epirubicin combination (at the dose of 175 and 90 mg/m(2), respectively) plus G-CSF to mobilize hematopoietic progenitors into the circulation.
  
  
  METHODS
  The study was conducted in a homogeneous cohort of 25 stage IV breast cancer patients showing response to three cycles of the same chemotherapy regimen and who were included in a high-dose chemotherapy program.
  
  
  RESULTS
  In most cases (68%) more than 5_10(6) CD34+ cells/kg b.w. (the threshold fixed in our study) were collected by a single leukapheresis, 28% and 4% of patients requiring 2 and 3 procedures, respectively. Based on the CD34+ cell count in the peripheral blood, most of the leukaphereses (53%) were performed on day 11 after chemotherapy. More than 50 CD34+ cells/mL along with a preleukapheresis WBC count between 10 and 20_10(9)/L predicted that only a single harvest would be required in 100% of cases. The evaluation of the clonogenic potential of collected cells showed that a large number of committed colony-forming cells (CFCs) and more primitive long-term culture-initiating cell (LTC-IC) hematopoietic progenitors were present in 20 harvests studied.
  
  
  CONCLUSIONS
  These data demonstrate that the epirubicin/paclitaxel combination followed by G-CSF, besides being a very active regimen in MBC, is effective in releasing large amounts of progenitor cells into the circulation which can then be safely employed to support myeloablative regimens.
authors.affiliation: Divisione di Oncologia Medica, Fondazione "S. Maugeri", via Ferrata 8, 27100 Pavia, Italy. czibera@fsm.it
authors.forename: C
authors.initials: C
authors.lastname: Zibera
authors.forename: P
authors.initials: P
authors.lastname: Pedrazzoli
authors.forename: L
authors.initials: L
authors.lastname: Ponchio
authors.forename: N
authors.initials: N
authors.lastname: Gibelli
authors.forename: A
authors.initials: A
authors.lastname: Lanza
authors.forename: G A
authors.initials: GA
authors.lastname: Da Prada
authors.forename: A
authors.initials: A
authors.lastname: Zambelli
authors.forename: C
authors.initials: C
authors.lastname: Perotti
authors.forename: L
authors.initials: L
authors.lastname: Torretta
authors.forename: L
authors.initials: L
authors.lastname: Salvaneschi
authors.forename: G
authors.initials: G
authors.lastname: Robustelli della Cuna
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000556:secondary* / Q000628:therapy*; D002999:Clone Cells; D003131:Combined Modality Therapy / Q000379:methods; D015251:Epirubicin / Q000627:therapeutic use*; D005260:Female; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007937:Leukapheresis / Q000379:methods; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D015251:Epirubicin; D017239:Paclitaxel