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A comparison of peripheral blood stem cell mobilisation after chemotherapy with cyclophosphamide as a single agent in doses of 4 g/m 2 or 7 g/m 2 in patients with advanced cancer
Author(s) -
Rowlings P. A.,
Bayly J. L.,
Rawling C. M.,
Juttner C. A.,
To L. B.
Publication year - 1992
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1992.tb04867.x
Subject(s) - medicine , cyclophosphamide , gastroenterology , chemotherapy , apheresis , regimen , surgery , cancer , urology , platelet
We used cyclophosphamide at a dose of 7 g/m 2 in patients with advanced cancer and compared the efficacy of this treatment to generate peripheral blood stem cells (PBSC) with the previously reported regimen of cyclophosphamide 4 g/m 2 in a similar group of patients. None of these patients received haemopoietic growth factors. Twenty‐two patients received 7 g/m 2 and 37 received 4 g/m 2 . PBSC were collected by apheresis after the leukocyte count recovered to 1.0times10 9 /L. The yield of colony forming unit‐granulocyte macrophage (CFU‐GM) was higher for the 7 g/m 2 group with a median of 35 times 10 4 /kg versus 15 times 10 4 /kg body weight (BW) (p 15 times 10 4 CFU‐GM/kg BW was higher in the 7 g/m 2 cyclophosphamide group (82%) than the 4 g/m 2 cyclophosphamide group (51%). The duration of significant neutropaenia was a median of 11 compared with nine days ( p <0.004) and all patients receiving 7 g/m 2 required admission to hospital and intravenous antibiotic therapy compared with 44% in the 4 g/m 2 group. There was one death during the period of neutropaenia after cyclophosphamide in each group. Nineteen per cent of patients required platelet transfusions after cyclophosphamide 7 g/m 2 compared with 18% after 4 g/m 2 . We conclude that the 7 g/m 2 cyclophosphamide gives a higher yield of haemopoietic progenitor cells than the 4 g/m 2 but at increased clinical toxicity. (Aust NZ J Med 1992; 22: 660ndash;664.)