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Title: | Ifosfamide in combination with paclitaxel or doxorubicin: Regimens which effectively mobilize peripheral blood progenitor cells while demonstrating anti-tumor activity in patients with metastatic breast cancer. | Authors: | Briggs P. ;Millward M.J.;Rischin D.;Francis P.;Gates P.;Chapple P.;Quinn M.;Juneja S.;Wolf M.;Januszewicz E.H.;Richardson G.;Scarlett J.;Brettell M.;Toner G.C.;Prince H.M.;Gardyn J. | Institution: | (Prince, Gardyn, Millward, Rischin, Francis, Gates, Chapple, Quinn, Juneja, Wolf, Januszewicz, Brettell, Toner) Blood and Marrow Transplant Service, Div. of Haematol. and Med. Oncology, Peter MacCallum Cancer Institute, Melbourne, Vic., Australia (Richardson, Scarlett, Briggs) Dept. Med. Oncol. Clin. Haematol., Monash Medical Centre, Melbourne, Vic., Australia (Prince) Div. of Haematol. and Med. Oncology, Peter MacCallum Cancer Institute, Locked Bag 1, A'Beckett St, Melbourne, Vic. 3000, Australia | Issue Date: | 19-Oct-2012 | Copyright year: | 1999 | Publisher: | Nature Publishing Group (Houndmills, Basingstoke, Hampshire RG21 6XS, United Kingdom) | Place of publication: | United Kingdom | Publication information: | Bone Marrow Transplantation. 23 (5) (pp 427-435), 1999. Date of Publication: 1999. | Abstract: | For patients with metastatic breast cancer (MBC) who undergo high-dose therapy with autologous peripheral blood progenitor cell (PBPC) transplantation, an important prerequisite is a mobilization regimen that efficiently mobilizes PBPCs while producing an effective anti-tumor effect. We prospectively evaluated ifosfamide-based chemotherapy for mobilization efficiency, toxicity and disease response in 37 patients. Patients received two cycles of the ifosfamide-based regimen; ifosfamide (5 g/m2 with conventional-dose cycle and 6 g/m2 with mobilization cycle) with either 50 mg/m2 doxorubicin (if limited prior anthracycline and/or progression more than 12 months after an anthracycline-based regimen) or 175 mg/m2 paclitaxel. For the mobilization cycle, all patients received additional G-CSF (10 mug/kg SC, daily) commencing 24 h after completion of chemotherapy. The target yield was > 6 x 106 CD34+ cells/kg, sufficient to support the subsequent three cycles of high-dose therapy. The mobilization therapy was well tolerated and the peak days for peripheral blood (PB) CD34+ cells were days 10-13 with no significant differences in the PB CD34+ cells mobilization kinetics between the ifosfamide-doxorubicin vs ifosfamide-paclitaxel regimens. The median PBPC CD34+ cell content ranged from 2.9 to 4.0 x 106/kg per day during days 9-14. After a median of 3 (range 1-5) collection days, the median total CD34+ cell, CFU-GM and MNC for all 44 individual sets of collections was 9.2 x 106/kg (range 0.16-54.9), 37 x 104/kg (range 5.7-247) and 7.3 x 108/kg (range 2.1-26.1), respectively. The PBPC target yield was achieved in 35 of the 37 patients. The overall response rate for the 31 evaluable patients was 68% with 10% having progressive disease. Thirty-three patients have subsequently received high-dose therapy consisting of three planned cycles of high-dose ifosfamide, thiotepa and paclitaxel with each cycle supported with PBPCs. Rapid neutrophil and platelet recovery has been observed. Ifosfamide with G-CSF in combination with doxorubicin or paclitaxel achieves effective mobilization of PBPC and anti-tumor activity with minimal toxicity. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1038/sj.bmt.1701606 | PubMed URL: | 10100555 [http://www.ncbi.nlm.nih.gov/pubmed/?term=10100555] | ISSN: | 0268-3369 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/33559 | Type: | Article | Subjects: | antineoplastic agent/do [Drug Dose] antineoplastic agent/dt [Drug Therapy] antineoplastic agent/pd [Pharmacology] CD34 antigen/ec [Endogenous Compound] *doxorubicin/ae [Adverse Drug Reaction] *doxorubicin/ct [Clinical Trial] *doxorubicin/cb [Drug Combination] *doxorubicin/cm [Drug Comparison] *doxorubicin/do [Drug Dose] *doxorubicin/dt [Drug Therapy] *doxorubicin/pd [Pharmacology] *ifosfamide/ae [Adverse Drug Reaction] *ifosfamide/ct [Clinical Trial] *ifosfamide/cb [Drug Combination] *ifosfamide/cm [Drug Comparison] *ifosfamide/do [Drug Dose] *ifosfamide/dt [Drug Therapy] *ifosfamide/pd [Pharmacology] mesna/cb [Drug Combination] mesna/dt [Drug Therapy] *paclitaxel/cb [Drug Combination] *paclitaxel/cm [Drug Comparison] *paclitaxel/do [Drug Dose] *paclitaxel/dt [Drug Therapy] *paclitaxel/pd [Pharmacology] recombinant granulocyte colony stimulating factor thiotepa/cb [Drug Combination] thiotepa/dt [Drug Therapy] *paclitaxel/ct [Clinical Trial] adult *antineoplastic activity article *breast cancer/dt [Drug Therapy] *breast cancer/th [Therapy] cell count clinical article drug efficacy female human intravenous drug administration male *metastasis/co [Complication] *metastasis/dt [Drug Therapy] *metastasis/th [Therapy] *mobilization neutrophil peripheral blood stem cell priority journal *stem cell stem cell transplantation subcutaneous drug administration thrombocyte thrombocytopenia/si [Side Effect] antineoplastic agent/ae [Adverse Drug Reaction] antineoplastic agent/ct [Clinical Trial] antineoplastic agent/cb [Drug Combination] antineoplastic agent/cm [Drug Comparison] *metastasis / *complication / *drug therapy / *therapy *mobilization neutrophil peripheral blood stem cell priority journal *stem cell stem cell transplantation subcutaneous drug administration article thrombocytopenia / side effect *antineoplastic activity adult thrombocyte *breast cancer / *drug therapy / *therapy cell count clinical article drug efficacy female human intravenous drug administration male |
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