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.
Junghanss
C
C
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
Leithäuser
M
M
Wilhelm
S
S
Kleine
H D
HD
Knopp
A
A
Decker
S
S
Alscher
A
A
Casper
J
J
Köhne
C H
CH
Freund
M
M
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