TY - JOUR
T1 - Rapid hematopoietic recovery after multicycle high-dose chemotherapy
T2 - Enhancement of filgrastim-induced progenitor-cell mobilization by recombinant human stem-cell factor
AU - Basser, Russell L.
AU - Bik To, L.
AU - Glenn Begley, C.
AU - Maher, Darryl
AU - Juttner, Christopher
AU - Cebon, Jonathan
AU - Mansfield, Rachel
AU - Olver, Jan
AU - Duggan, Geraint
AU - Szer, Jeffrey
AU - Collins, John
AU - Schwartz, Bernadette
AU - Marty, Jennifer
AU - Menchaca, Dora
AU - Sheridan, William P.
AU - Fox, Richard M.
AU - Green, Michael D.
PY - 1998/5
Y1 - 1998/5
N2 - Purpose: To assess the mobilization potential and safety of recombinant human stem-cell factor (SCF) when coadministered with filgrastim to untreated women with poor-prognosis breast cancer. Patients and Methods: Eligible women had breast cancer with 10 or more positive axillary nodes, or estrogen receptor-negative tumor with 4 positive nodes, or stage III disease. Patients were randomized to receive SCF plus filgrastim or filgrastim alone. Filgrastim 12 μg/kg daily was administered for 6 days by continuous subcutaneous infusion. SCF was administered by daily subcutaneous injection at 5, 10, or 15 μg/kg concurrent with filgrastim for 7 days, or 10 μg/kg daily starting 3 days before filgrastim for a total of 10 days (SCF pretreatment). Apheresis was performed on days 5, 6, and 7 of filgrastim administration. Patients then had three cycles of epirubicin 200 mg/m2 and cyclophosphamide 4 g/m2 every 28 days, each supported by one third of the apheresis product. Results: Sixty-two women were treated. Greater yields occurred in patients who received SCF 10 μg/kg daily plus filgrastim than those who received filgrastim alone (P= .013 far CD34+ cells; P = .07 for granulocyte-macrophage colony-forming cells [GM-CFCs]). The difference was more marked with SCF-pretreatment than concurrent SCF. Fewer aphereses were required to reach the predetermined target of peripheral-blood progenitor/stem cells (PBPCs) in women who received SCF. SCF was generally well tolerated. Hematologic recovery was rapid after each of the three cycles of chemotherapy. There was no difference in recovery between the different treatment groups. Conclusion: Mobilization of PBPCs by filgrastim is significantly enhanced by coadministration of SCF, and commencing SCF before filgrastim can optimize this effect. SCF has the potential to reduce the number of aphereses required to collect a target number of PBPCs.
AB - Purpose: To assess the mobilization potential and safety of recombinant human stem-cell factor (SCF) when coadministered with filgrastim to untreated women with poor-prognosis breast cancer. Patients and Methods: Eligible women had breast cancer with 10 or more positive axillary nodes, or estrogen receptor-negative tumor with 4 positive nodes, or stage III disease. Patients were randomized to receive SCF plus filgrastim or filgrastim alone. Filgrastim 12 μg/kg daily was administered for 6 days by continuous subcutaneous infusion. SCF was administered by daily subcutaneous injection at 5, 10, or 15 μg/kg concurrent with filgrastim for 7 days, or 10 μg/kg daily starting 3 days before filgrastim for a total of 10 days (SCF pretreatment). Apheresis was performed on days 5, 6, and 7 of filgrastim administration. Patients then had three cycles of epirubicin 200 mg/m2 and cyclophosphamide 4 g/m2 every 28 days, each supported by one third of the apheresis product. Results: Sixty-two women were treated. Greater yields occurred in patients who received SCF 10 μg/kg daily plus filgrastim than those who received filgrastim alone (P= .013 far CD34+ cells; P = .07 for granulocyte-macrophage colony-forming cells [GM-CFCs]). The difference was more marked with SCF-pretreatment than concurrent SCF. Fewer aphereses were required to reach the predetermined target of peripheral-blood progenitor/stem cells (PBPCs) in women who received SCF. SCF was generally well tolerated. Hematologic recovery was rapid after each of the three cycles of chemotherapy. There was no difference in recovery between the different treatment groups. Conclusion: Mobilization of PBPCs by filgrastim is significantly enhanced by coadministration of SCF, and commencing SCF before filgrastim can optimize this effect. SCF has the potential to reduce the number of aphereses required to collect a target number of PBPCs.
UR - http://www.scopus.com/inward/record.url?scp=0031859858&partnerID=8YFLogxK
U2 - 10.1200/JCO.1998.16.5.1899
DO - 10.1200/JCO.1998.16.5.1899
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AN - SCOPUS:0031859858
SN - 0732-183X
VL - 16
SP - 1899
EP - 1908
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 5
ER -
