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Mobilized peripheral blood progenitor cells (pbpc) in support of tandem cycles of high-dose chemotherapy (hdc)

Academic Article
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Overview

authors

  • Meisenberg, B. R.
  • Miller, W. E.
  • Mc Millan, Robert

publication date

  • December 1996

journal

  • Bone Marrow Transplantation  Journal

abstract

  • We evaluated the efficacy, toxicity and feasibility of two cycles of high-dose chemotherapy (HDC), each supported with mobilized peripheral blood progenitor cells (PBPC). Ninety-six patients with metastatic or high-risk cancers received disease-specific HDC regimens. The first cycle consisted of cyclophosphamide 6000 mg/m2, thiotepa 500 mg/m2 and carboplatin 1200 mg/m2. Alternatively, some patients received etoposide 1800 mg/m2 substituted for thiotepa. A second cycle was planned 6-8 weeks later and consisted of mitoxantrone 60 mg/m2 with either melphalan 140 mg/m2 or thiotepa 600 mg/m2. PBPC were mobilized with either growth factor alone or cyclophosphamide followed by growth factor(s). Thirty-four of 96 enrolled patients (35%) did not receive the second cycle. The reasons were: patient refusal (15); insurance refusal (three); toxicities of cycle 1 (seven); no response to cycle 1 (four); and inadequate mobilization or poor engraftment, (five). Of the 33 patients who entered cycle 2 with measurable disease, 28 demonstrated further response after cycle 2 (including 10 who entered CR). One patient died of toxicity after each cycle. Hematologic recovery was rapid and complete in most patients. Tandem cycles of high-dose chemotherapy supported by PBPC are feasible and safe, although many patients fail to receive the second treatment. Preliminary evaluation shows evidence of further antitumor efficacy following cycle 2.

subject areas

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Bone Marrow Diseases
  • Bone Marrow Transplantation
  • Carboplatin
  • Cyclophosphamide
  • Drug Administration Schedule
  • Etoposide
  • Feasibility Studies
  • Female
  • Granulocyte Colony-Stimulating Factor
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukapheresis
  • Male
  • Melphalan
  • Middle Aged
  • Mitoxantrone
  • Neoplasms
  • Patient Acceptance of Health Care
  • Remission Induction
  • Salvage Therapy
  • Thiotepa
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Treatment Outcome
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Research

keywords

  • high-dose chemotherapy
  • peripheral blood progenitor cell transplant
  • tandem cycles
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Identity

International Standard Serial Number (ISSN)

  • 0268-3369

PubMed ID

  • 8971377
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Additional Document Info

start page

  • 1087

end page

  • 1093

volume

  • 18

issue

  • 6

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