Multicyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood.

2.50
Hdl Handle:
http://hdl.handle.net/10541/99447
Title:
Multicyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood.
Authors:
Pettengell, Ruth; Woll, Penella J; Thatcher, Nick; Dexter, T Michael; Testa, Nydia G
Abstract:
PURPOSE: To support multicyclic, dose-intensive chemotherapy, we assessed the effects of reinfusing hematopoietic progenitors collected at each cycle in leukapheresis product or whole blood. PATIENTS AND METHODS: Twenty-five patients with small-cell lung cancer (SCLC) were treated with six cycles of ifosfamide, carboplatin, and etoposide (ICE) with granulocyte colony-stimulating factor (G-CSF) 300 micrograms/d subcutaneously (SC) on days 4 to 15. Hematopoietic progenitors collected during each cycle were reinfused on day 3 of the next cycle. Cohort 1 (n = 6) was treated every 3 weeks, with leukapheresis after 2 weeks and cryopreservation of the leukapheresis product. Chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 100 x 10(9)/L. Cohort 2 (n = 7) was treated every 2 weeks, with leukapheresis on day 1 of the next cycle and storage of the leukapheresis product at 4 degrees C. Cohort 3 (n = 12) was treated every 2 weeks, with 500 to 750 mL of blood drawn by venesection on day 1 of the next cycle and stored at 4 degrees C. In cohorts 2 and 3, chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 30 x 10(9)/L. Blood and leukapheresis products were assayed for hematopoietic progenitors. RESULTS: ICE chemotherapy with G-CSF was effective in mobilizing blood progenitors (median, 120-fold). Long-term cultures showed no evidence of stem-cell depletion. The cytotoxic dose-intensity of standard every-4-weeks ICE is 100%. In the first three cycles, it was 134% (median) in cohort 1 and 200% in cohorts 2 and 3 (P < .0001). Toxicity and supportive care requirements were not increased. CONCLUSION: The dose-intensity of ICE chemotherapy can be doubled by reinfusing hematopoietic progenitors collected by leukapheresis or venesection and stored at 4 degrees C.
Affiliation:
Department of Medical Oncology, Christie Hospital, Manchester, United Kingdom.
Citation:
Multicyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood. 1995, 13 (1):148-56 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
Jan-1995
URI:
http://hdl.handle.net/10541/99447
PubMed ID:
7528271
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications ; All Paterson Institute for Cancer Research

Full metadata record

DC FieldValue Language
dc.contributor.authorPettengell, Ruthen
dc.contributor.authorWoll, Penella Jen
dc.contributor.authorThatcher, Nicken
dc.contributor.authorDexter, T Michaelen
dc.contributor.authorTesta, Nydia Gen
dc.date.accessioned2010-05-20T15:33:57Z-
dc.date.available2010-05-20T15:33:57Z-
dc.date.issued1995-01-
dc.identifier.citationMulticyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood. 1995, 13 (1):148-56 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid7528271-
dc.identifier.urihttp://hdl.handle.net/10541/99447-
dc.description.abstractPURPOSE: To support multicyclic, dose-intensive chemotherapy, we assessed the effects of reinfusing hematopoietic progenitors collected at each cycle in leukapheresis product or whole blood. PATIENTS AND METHODS: Twenty-five patients with small-cell lung cancer (SCLC) were treated with six cycles of ifosfamide, carboplatin, and etoposide (ICE) with granulocyte colony-stimulating factor (G-CSF) 300 micrograms/d subcutaneously (SC) on days 4 to 15. Hematopoietic progenitors collected during each cycle were reinfused on day 3 of the next cycle. Cohort 1 (n = 6) was treated every 3 weeks, with leukapheresis after 2 weeks and cryopreservation of the leukapheresis product. Chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 100 x 10(9)/L. Cohort 2 (n = 7) was treated every 2 weeks, with leukapheresis on day 1 of the next cycle and storage of the leukapheresis product at 4 degrees C. Cohort 3 (n = 12) was treated every 2 weeks, with 500 to 750 mL of blood drawn by venesection on day 1 of the next cycle and stored at 4 degrees C. In cohorts 2 and 3, chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 30 x 10(9)/L. Blood and leukapheresis products were assayed for hematopoietic progenitors. RESULTS: ICE chemotherapy with G-CSF was effective in mobilizing blood progenitors (median, 120-fold). Long-term cultures showed no evidence of stem-cell depletion. The cytotoxic dose-intensity of standard every-4-weeks ICE is 100%. In the first three cycles, it was 134% (median) in cohort 1 and 200% in cohorts 2 and 3 (P < .0001). Toxicity and supportive care requirements were not increased. CONCLUSION: The dose-intensity of ICE chemotherapy can be doubled by reinfusing hematopoietic progenitors collected by leukapheresis or venesection and stored at 4 degrees C.en
dc.language.isoenen
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subjectLung Canceren
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBlood Transfusion, Autologous-
dc.subject.meshCarboplatin-
dc.subject.meshCarcinoma, Small Cell-
dc.subject.meshCause of Death-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshEtoposide-
dc.subject.meshFeasibility Studies-
dc.subject.meshFemale-
dc.subject.meshGranulocyte Colony-Stimulating Factor-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshIfosfamide-
dc.subject.meshLeukapheresis-
dc.subject.meshLung Neoplasms-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPilot Projects-
dc.subject.meshPlatelet Transfusion-
dc.titleMulticyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medical Oncology, Christie Hospital, Manchester, United Kingdom.en
dc.identifier.journalJournal of Clinical Oncologyen

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