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dc.contributor.authorWoll, Penella J
dc.contributor.authorThatcher, Nick
dc.contributor.authorLomax, Lyn
dc.contributor.authorHodgetts, Jackie
dc.contributor.authorLee, Siow Ming
dc.contributor.authorBurt, Paul A
dc.contributor.authorStout, Ronald
dc.contributor.authorSimms, T
dc.contributor.authorDavies, R
dc.contributor.authorPettengell, Ruth
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.
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
html.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.


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