title: High-dose ifosfamide and etoposide with filgrastim for stem cell mobilization in patients with advanced ovarian cancer.
abstract: High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation has shown promise as treatment for recurrent or persistent epithelial ovarian cancer. We evaluated the stem cell mobilization regimen of high-dose ifosfamide plus etoposide in 32 patients with epithelial ovarian cancer, who had a positive second-look laparatomy or recurrent disease. Ifosfamide was given at 10 g/m2 by continuous i.v. from days 1 to 3. Etoposide was given at 150 mg/m2 every 12 h for six doses on days 1-3. Filgrastim was given at 10 microg/kg/d s.c. from day 5 until the completion of peripheral blood stem cell harvest. Fourteen of 32 patients had measurable or evaluable disease before mobilization therapy and were assessed for response. In nine (64%) of the 14 patients, treatment response was demonstrated, and these patients received a second cycle of mobilization therapy. The target CD34+ cell dose (>8 x 106 cells/kg) was achieved with a median of one apheresis (range 1-5). A median of 25.1 (range 8.0-122.5) x 106 CD34+ cells/kg body weight was collected. Non-hematologic toxicity was limited to grade 2 renal dysfunction in one patient and grade 2 hepatic dysfunction in three patients. In this patient group, high-dose ifosfamide plus etoposide with filgrastim support was well tolerated, lead to successful stem cell harvest and had antitumor activity.
authors.affiliation: Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Donato
authors.forename: D
authors.initials: D
authors.lastname: Gershenson
authors.forename: C
authors.initials: C
authors.lastname: Ippoliti
authors.forename: J T
authors.initials: JT
authors.lastname: Wharton
authors.forename: R C
authors.initials: RC
authors.lastname: Bast
authors.forename: A
authors.initials: A
authors.lastname: Aleman
authors.forename: P
authors.initials: P
authors.lastname: Anderlini
authors.forename: J G
authors.initials: JG
authors.lastname: Gajewski
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.forename: J
authors.initials: J
authors.lastname: Molldrem
authors.forename: N
authors.initials: N
authors.lastname: Ueno
authors.forename: J
authors.initials: J
authors.lastname: Lauppe
authors.forename: M
authors.initials: M
authors.lastname: Korbling
authors.forename: J
authors.initials: J
authors.lastname: Boyer
authors.forename: D
authors.initials: D
authors.lastname: Bodurka-Bevers
authors.forename: M
authors.initials: M
authors.lastname: Bevers
authors.forename: T
authors.initials: T
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Freedman
authors.forename: C
authors.initials: C
authors.lastname: Levenback
authors.forename: J
authors.initials: J
authors.lastname: Wolf
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001781:Blood Component Removal; D002277:Carcinoma / Q000628:therapy*; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D015080:Mesna / Q000627:therapeutic use; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000628:therapy*; D011994:Recombinant Proteins; D014182:Transplantation, Autologous
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D015080:Mesna; D000069585:Filgrastim; D007069:Ifosfamide