title: Factors determining the actual received dose intensity in a program of multicyclic dose-intensive alternating chemotherapy with sequential stem cell support.
abstract: Dose intensity has been related to clinical outcome in several solid tumors. We studied the influence of clinical and cellular parameters on dose intensity received in a series of 53 patients with metastatic breast cancer or advanced ovarian cancer. They received courses of cisplatin 120 mg/m(2) plus etoposide 600 mg/m(2) alternating every 14 days with ifosfamide 8 g/m(2) plus paclitaxel 200--350 mg/m(2). Blood stem cell support was administered after every course except for the first one. Patients with excellent mobilization underwent immunomagnetic selection of CD34+ cells. We found a significant inverse correlation between the CD34+ cell dose infused and the delay for the administration of the next cycle. A CD34+ cell dose between 1.5 and 5 x 10(6)/kg per cycle was found to be feasible and was followed by a median delay of 1 day (not different from doses above 5 x 10(6)/kg). Three factors independently predicted the actually received dose intensity in a multiple regression model (R(2) = 0.4): previous autologous transplantation, eligibility for immunomagnetic selection (excellent response to mobilization) and median CD34+ cell dose received along the treatment.
authors.affiliation: Department of Oncology and Cell Therapy Area, Clínica Universitaria de Navarra, Pamplona, Spain. jpcalvo@unav.es
authors.forename: J
authors.initials: J
authors.lastname: Pérez-Calvo
authors.forename: M
authors.initials: M
authors.lastname: Martínez-Aguillo
authors.forename: S
authors.initials: S
authors.lastname: García-Rayo
authors.forename: T
authors.initials: T
authors.lastname: Ramón y Cajal
authors.forename: M
authors.initials: M
authors.lastname: Santisteban
authors.forename: J M
authors.initials: JM
authors.lastname: Ordóñez
authors.forename: S
authors.initials: S
authors.lastname: Inogés
authors.forename: M L
authors.initials: ML
authors.lastname: Subirá
authors.forename: S
authors.initials: S
authors.lastname: Martín-Algarra
authors.forename: A
authors.initials: A
authors.lastname: Brugarolas
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy*; D002452:Cell Count; D002945:Cisplatin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D018189:Immunomagnetic Separation; D008875:Middle Aged; D008954:Models, Biological; D010051:Ovarian Neoplasms / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D013234:Stem Cells / Q000276:immunology*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D005047:Etoposide; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide