High-dose etoposide phosphate and G-CSF mobilizes peripheral blood stem cells in patients that previously failed to mobilize.
Ten consecutive patients in our unit who had failed to mobilize a sufficient stem cell yield after either an initial or several mobilization regimens received high-dose etoposide phosphate (1500-2000 mg/m2) followed by granulocyte colony-stimulating factor (G-CSF; 10 micrograms/kg per day) to stimulate mobilization. Eight of the ten patients were apheresed. A median of 2.1 x 10(6) CD34+/kg (range 0-5.2) was collected. The number of CD34+ cells/microliter peripheral blood (pB) was significantly increased compared to the first-line mobilization [median 13.0 (range 2.68-29) versus median 4.76 (range 1.36-12); P < 0.05]. Besides hematotoxicity and four cases of infection (WHO grade 3), no major side effects were seen. The median duration of neutropenia was short (5 days, range 0-10), which is important in heavily pretreated patients. These results indicate that high-dose etoposide phosphate with G-CSF is safe, well tolerated, and may be effective in peripheral blood stem cell (PBSC) mobilization in patients who had previously failed to mobilize.
Fred Hutchinson Cancer Research Center, Clinical Research Division, 1100 Fairview Avenue North, D1-100, PO Box 19024, Seattle, WA 98102-1024, USA. cjunghan@fhcrc.org
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Junghanss
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Leithäuser
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Wilhelm
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Kleine
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Knopp
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Decker
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Alscher
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Casper
C H
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Köhne
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Freund
D000328:Adult; D002822:Choriocarcinoma / Q000188:drug therapy; D003520:Cyclophosphamide / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000493:pharmacokinetics* / Q000633:toxicity; D005260:Female; D018237:Germinoma / Q000188:drug therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000493:pharmacokinetics* / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000633:toxicity; D013810:Therapeutic Equivalency; D019172:Transplantation Conditioning; D014916:Whole-Body Irradiation
D009943:Organophosphorus Compounds; D016179:Granulocyte Colony-Stimulating Factor; C061400:etoposide phosphate; D005047:Etoposide; D003520:Cyclophosphamide