Premium
Peripheral blood progenitor cell collection after epirubicin, paclitaxel, and cisplatin combination chemotherapy using EPO‐based cytokine regimens: a randomized comparison of G–CSF and sequential GM–/G–CSF
Author(s) -
Perillo Alessandro,
Pierelli Luca,
Scambia Giovanni,
Serafini Riccardo,
Paladini Umberto,
Salerno Maria Giovanna,
Bonanno Giuseppina,
Fattorossi Andrea,
Leone Giuseppe,
Mancuso Salvatore,
Menichella Giacomo
Publication year - 2001
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2001.41050674.x
Subject(s) - medicine , epirubicin , chemotherapy , granulocyte colony stimulating factor , erythropoietin , gastroenterology , progenitor cell , apheresis , urology , cyclophosphamide , platelet , stem cell , biology , genetics
BACKGROUND: The peripheral blood progenitor cell (PBPC) mobilization capacity of EPO in association with either G–CSF or sequential GM–CSF/G–CSF was compared in a randomized fashion after epirubicin, paclitaxel, and cisplatin (ETP) chemotherapy. STUDY DESIGN AND METHODS: Forty patients with stage IIIB, IIIC, or IV ovarian carcinoma were enrolled in this randomized comparison of mobilizing capacity and myelopoietic effects of G–CSF + EPO and GM–/G–CSF + EPO following the first ETP chemotherapy treatment. After ETP chemotherapy (Day 1), 20 patients received G–CSF 5 μg per kg per day from Day 2 to Day 13 and 20 patients received GM–CSF 5 μg per kg per day from Day 2 to Day 6 followed by G–CSF 5 μg per kg per day from Day 7 to Day 13. EPO (150 IU per kg) was given every other day from Day 2 to Day 13 to all patients in both arms of the study. Apheresis (two blood volumes) was performed during hematologic recovery. RESULTS: The magnitude of CD34+ cell mobilization and the abrogation of patients' myelosuppression were comparable in both study arms; however, GM–/G–CSF + EPO patients had significantly higher CD34+ yields because of a higher CD34+ cell collection efficiency (57.5% for GM–/G–CSF + EPO and 46.3% for G–CSF + EPO patients; p = 0.0009). Identical doses of PBPCs mobilized by GM–/G–CSF + EPO and G–CSF + EPO drove comparable hematopoietic recovery after reinfusion in patients treated with identical high‐dose chemotherapy. CONCLUSION: The sequential administration of GM–CSF and G–CSF in combination with EPO is feasible and improves the PBPC collection efficiency after platinum‐based intensive polichemotherapy, associating high PBPC mobilization to high collection efficiency during apheresis.