High-dose Versus Low-dose Cyclophosphamide in Combination with G-CSF for Peripheral Blood Progenitor Cell Mobilization.
10.3904/kjim.2005.20.3.224
- Author:
Jin Seok AHN
1
;
Seonyang PARK
;
Seock Ah IM
;
Sung Soo YOON
;
Jong Seok LEE
;
Byoung Kook KIM
;
Soo Mee BANG
;
Eun Kyung CHO
;
Jae Hoon LEE
;
Chul Won JUNG
;
Hugh Chul KIM
;
Chu Myung SEONG
;
Moon Hee LEE
;
Chul Soo KIM
;
Keun Seok LEE
;
Jung Ae LEE
;
Myung Ju AHN
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea.
- Publication Type:Original Article ; Comparative Study ; Randomized Controlled Trial
- Keywords:
Cyclophosphamide;
Hematopoietic stem cell mobilization;
Progenitor cell;
Granulocyte colony-stimulating factor
- MeSH:
Transplantation Conditioning;
Stem Cells/*drug effects;
Recombinant Proteins/administration & dosage/pharmacology;
Prospective Studies;
Myeloablative Agonists/*administration & dosage/pharmacology;
Middle Aged;
Male;
Lymphoma, Non-Hodgkin/*drug therapy;
Leukapheresis;
Humans;
*Hematopoietic Stem Cell Mobilization;
Granulocyte Colony-Stimulating Factor/*administration & dosage/pharmacology;
Female;
Drug Therapy, Combination;
Cyclophosphamide/*administration & dosage/pharmacology;
Chemotherapy, Adjuvant;
Breast Neoplasms/*drug therapy;
Adult
- From:The Korean Journal of Internal Medicine
2005;20(3):224-231
- CountryRepublic of Korea
- Language:English
-
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 2x10 (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. 9.9x10 (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 III 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. CONCLUSION: Low-dose CY plus lenograstim is a safe and effective mobilizing regimen.
