Korean J Intern Med.
2005 Sep;20(3):224-231. 10.3904/kjim.2005.20.3.224.
High-dose Versus Low-dose Cyclophosphamide in Combination with G-CSF for Peripheral Blood Progenitor Cell Mobilization
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea.
- 2Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. seonpark@plaza.snu.ac.kr
- 3Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea.
- 4Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
- 6Department of Internal Medicine, College of Medine, Ewha Womans University, Seoul, Korea.
- 7Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea.
- 8Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- KMID: 1782234
- DOI: http://doi.org/10.3904/kjim.2005.20.3.224
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.
Keyword
MeSH Terms
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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
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