Use of hematopoietic progenitors in whole blood to support dose-dense chemotherapy: a randomized phase II trial in small-cell lung cancer patients.

2.50
Hdl Handle:
http://hdl.handle.net/10541/84140
Title:
Use of hematopoietic progenitors in whole blood to support dose-dense chemotherapy: a randomized phase II trial in small-cell lung cancer patients.
Authors:
Woll, Penella J; Thatcher, Nick; Lomax, Lyn; Hodgetts, Jackie; Lee, Siow Ming; Burt, Paul A; Stout, Ronald; Simms, T; Davies, R; Pettengell, Ruth
Abstract:
PURPOSE: Small-cell lung cancer (SCLC) is exquisitely chemosensitive, but few patients are cured by conventional chemoradiotherapy. Recent studies suggest that increased cytotoxic dose-intensity might improve survival. In this randomized phase II study, we tested the feasibility of dose intensification using sequential reinfusion of hematopoietic progenitors in whole blood. PATIENTS AND METHODS: SCLC patients with a favorable prognosis were treated with six cycles of ifosfamide, carboplatin, and etoposide (ICE), at 4-week (standard treatment) or 2-week (intensified treatment) intervals. Intensified treatment was supported by daily subcutaneous filgrastim injections and reinfusion of 750 mL of autologous blood collected immediately before each cycle. RESULTS: Fifty consecutive patients were randomized to standard (n = 25) or intensified (n = 25) ICE. A total of 94% completed at least three treatment cycles, and 70% completed six cycles; 96% of treatments were given at full dose. The planned dose-intensity was 1.0 for standard and 2.0 for intensified ICE. The median received dose-intensity for cycles 1 through 3 was 0.99 (range, 0.33 to 1.02) for the standard treatment arm and 1.80 (range, 0.99 to 1.97) for the intensified treatment arm (P <.001). Over all six cycles, the median received dose-intensity was 0.95 (range, 0.17 to 1.03) for the standard treatment arm and 1.60 (range, 0.60 to 2.01) for the intensified treatment arm (P <.001). Febrile neutropenia was more common on the standard treatment arm (84% v 56%), resulting in more days of intravenous antibiotics (median, 10 v 3 days; P =.035). Transfusion requirements were similar in the two groups. CONCLUSION: Sequential reinfusion of hematopoietic progenitors in whole blood can safely support substantial increases in dose-intensity of ICE chemotherapy for SCLC.
Affiliation:
Cancer Research Campaign Department of Clinical Oncology, City Hospital, Nottingham, UK. penella.woll@nott.ac.uk
Citation:
Use of hematopoietic progenitors in whole blood to support dose-dense chemotherapy: a randomized phase II trial in small-cell lung cancer patients. 2001, 19 (3):712-9 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
1-Feb-2001
URI:
http://hdl.handle.net/10541/84140
PubMed ID:
11157022
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorWoll, Penella Jen
dc.contributor.authorThatcher, Nicken
dc.contributor.authorLomax, Lynen
dc.contributor.authorHodgetts, Jackieen
dc.contributor.authorLee, Siow Mingen
dc.contributor.authorBurt, Paul Aen
dc.contributor.authorStout, Ronalden
dc.contributor.authorSimms, Ten
dc.contributor.authorDavies, Ren
dc.contributor.authorPettengell, Ruthen
dc.date.accessioned2009-10-13T09:03:46Z-
dc.date.available2009-10-13T09:03:46Z-
dc.date.issued2001-02-01-
dc.identifier.citationUse of hematopoietic progenitors in whole blood to support dose-dense chemotherapy: a randomized phase II trial in small-cell lung cancer patients. 2001, 19 (3):712-9 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid11157022-
dc.identifier.urihttp://hdl.handle.net/10541/84140-
dc.description.abstractPURPOSE: Small-cell lung cancer (SCLC) is exquisitely chemosensitive, but few patients are cured by conventional chemoradiotherapy. Recent studies suggest that increased cytotoxic dose-intensity might improve survival. In this randomized phase II study, we tested the feasibility of dose intensification using sequential reinfusion of hematopoietic progenitors in whole blood. PATIENTS AND METHODS: SCLC patients with a favorable prognosis were treated with six cycles of ifosfamide, carboplatin, and etoposide (ICE), at 4-week (standard treatment) or 2-week (intensified treatment) intervals. Intensified treatment was supported by daily subcutaneous filgrastim injections and reinfusion of 750 mL of autologous blood collected immediately before each cycle. RESULTS: Fifty consecutive patients were randomized to standard (n = 25) or intensified (n = 25) ICE. A total of 94% completed at least three treatment cycles, and 70% completed six cycles; 96% of treatments were given at full dose. The planned dose-intensity was 1.0 for standard and 2.0 for intensified ICE. The median received dose-intensity for cycles 1 through 3 was 0.99 (range, 0.33 to 1.02) for the standard treatment arm and 1.80 (range, 0.99 to 1.97) for the intensified treatment arm (P <.001). Over all six cycles, the median received dose-intensity was 0.95 (range, 0.17 to 1.03) for the standard treatment arm and 1.60 (range, 0.60 to 2.01) for the intensified treatment arm (P <.001). Febrile neutropenia was more common on the standard treatment arm (84% v 56%), resulting in more days of intravenous antibiotics (median, 10 v 3 days; P =.035). Transfusion requirements were similar in the two groups. CONCLUSION: Sequential reinfusion of hematopoietic progenitors in whole blood can safely support substantial increases in dose-intensity of ICE chemotherapy for SCLC.en
dc.language.isoenen
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subjectLung Canceren
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBlood Platelets-
dc.subject.meshCarboplatin-
dc.subject.meshCarcinoma, Small Cell-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshEtoposide-
dc.subject.meshFemale-
dc.subject.meshGranulocyte Colony-Stimulating Factor-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshIfosfamide-
dc.subject.meshLung Neoplasms-
dc.subject.meshMale-
dc.subject.meshMesna-
dc.subject.meshMiddle Aged-
dc.subject.meshPlatelet Count-
dc.subject.meshQuality of Life-
dc.titleUse of hematopoietic progenitors in whole blood to support dose-dense chemotherapy: a randomized phase II trial in small-cell lung cancer patients.en
dc.typeArticleen
dc.contributor.departmentCancer Research Campaign Department of Clinical Oncology, City Hospital, Nottingham, UK. penella.woll@nott.ac.uken
dc.identifier.journalJournal of Clinical Oncologyen

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