Intensive dose ifosfamide and etoposide with G-CSF for stem cell mobilization in patients with non-Hodgkin's lymphoma.
We studied 36 patients with non-Hodgkin's lymphoma to evaluate the stem cell yield following recovery from intensive dose ifosfamide and etoposide given as mobilization chemotherapy. We also assessed the toxicity of the regimen and engraftment kinetics. All patients had intermediate grade lymphoma and had either failed to achieve a complete remission to induction chemotherapy or had relapsed. Patients received ifosfamide 10 g/m2 IV total dose given over 72 hours, etoposide 150 mg/m2 IV every 12 hours for 6 doses and G-CSF 10 microg/kg/d. Thirty-four patients went on to receive high-dose chemotherapy with BEAM or with CVP and BEAM. A median of 2 (1-10) apheresis was required to reach the target CD34+ count of >4 x 10(6)/kg. A median of 13.1 CD34+ cells/kg (4.1-148) was obtained. Toxicity was limited to mucositis in 3 patients, transient confusion and transient rise in liver function tests in 3 and 2 patients respectively. The median time to engraftment was 10 days (8-17) for all the patients undergoing high-dose chemotherapy. The regimen of intensive dose ifosfamide and etoposide along with G-CSF is well tolerated and in this group of patients has lead to successful stem cell harvests and sustained engraftment.
Donato
M L
ML
The University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Champlin
R E
RE
Van Besien
K W
KW
Korbling
M
M
Cabanillas
F
F
Anderlini
P
P
Gajewski
J G
JG
Lauppe
J
J
Durett
A
A
Andersson
B
B
Giralt
S
S
Khouri
I
I
Hagemeister
F
F
Romaguera
J E
JE
Sarris
A
A
McLaughlin
P
P
Younes
A
A
Ippoliti
C
C
Blamble
D A
DA
Hester
J
J
Gee
A
A
Rodriguez
M A
MA
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage*; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage*; D008228:Lymphoma, Non-Hodgkin / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous
D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D007069:Ifosfamide