title: High-dose versus low-dose cyclophosphamide in combination with G-CSF for peripheral blood progenitor cell mobilization.
abstract: BACKGROUND
  To compare the mobilizing effects and toxicities of two different doses of cyclophosphamide (CY) plus lenograstim (glycosylated G-CSF), we performed a prospective randomized study by enrolling patients suffering with either high-risk Non-Hodgkin's lymphoma (NHL) or breast cancer undergoing ablative chemotherapy.
  
  
  METHODS
  The NHL patients received 4 cycles of CHOP and the breast cancer patients received 2-3 cycles of FAC (FEC) adjuvant chemotherapy. Then, the patients were randomly allocated to receive CY 4 g/m2 (arm A) or 1.5 g/m2 (arm B) in combination with lenograstim. Large volume leukapheresis was carried out and it was continued daily until the target cell dose of 2 x 10(6) CD34+ cell/kg was reached.
  
  
  RESULTS
  Twenty-seven patients were enrolled in the study. The median number of leukaphereis sessions actually performed was 2.5 sessions in arm A and 3 sessions in arm B. The target cell dose was obtained with the median number of one leukapheresis session in both arms of the study (p=0.09). The collected number of CD34+ cells in the leukapheresis products was higher in arm A than arm B (22.4 vs. 9.9 x 10(6)/kg, respectively, p=0.05). Grade III or IV leukopenia was present in 14/15 patients (94%) in arm A and in 1/12 patients (8%) in arm B (p<0.0001). Grade Ill or IV thrombocytopenia was present in 8/15 patients (54%) in arm A, but this was not present in any patients of arm B (p=0.0004). Neutropenic fever occurred in 6/15 patients (40%) in arm A, and in 1/12 patients (8%) in arm B (p=0.09). The hematological recovery of the leukocytes and platelets after transplantation was not statistically different between the two doses.
  
  
  CONCLUSIONS
  Low-dose CY plus lenograstim is a safe and effective mobilizing regimen.
authors.affiliation: Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea .
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Ahn
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Jong-Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Byoung Kook
authors.initials: BK
authors.lastname: Kim
authors.forename: Soo-Mee
authors.initials: SM
authors.lastname: Bang
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Cho
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Hugh Chul
authors.initials: HC
authors.lastname: Kim
authors.forename: Chu Myung
authors.initials: CM
authors.lastname: Seong
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Lee
authors.forename: Chul Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Keun Seok
authors.initials: KS
authors.lastname: Lee
authors.forename: Jung Ae
authors.initials: JA
authors.lastname: Lee
authors.forename: Myung-Ju
authors.initials: MJ
authors.lastname: Ahn
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D000078224:Lenograstim; D007937:Leukapheresis; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage* / Q000494:pharmacology; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D013234:Stem Cells / Q000187:drug effects*; D019172:Transplantation Conditioning
chemical_list: D019653:Myeloablative Agonists; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim; D003520:Cyclophosphamide