紫杉醇、环磷酰胺及重组人粒细胞集落刺激因子治疗后乳腺癌和卵巢癌患者的外周血干细胞采集

Peripheral-blood stem-cell collections after paclitaxel, cyclophosphamide, and recombinant human granulocyte colony-stimulating factor in patients with breast and ovarian cancer.

作者信息

Demirer T, Rowley S, Buckner C D, Appelbaum F R, Lilleby K, Storb R, Schiffman K, Bensinger W I

机构信息

University of Washington School of Medicine, Fred Hutchinson Cancer Research Center, Seattle 98104, USA.

出版信息

J Clin Oncol. 1995 Jul;13(7):1714-9. doi: 10.1200/JCO.1995.13.7.1714.

DOI:10.1200/JCO.1995.13.7.1714

PMID:7541450

Abstract

PURPOSE

Here we evaluate Taxol (paclitaxel; Bristol-Myers Squibb, Princeton, NJ) and cyclophosphamide (CY) with recombinant human granulocyte colony-stimulating factor (rhG-CSF) for mobilization of peripheral-blood stem cells (PBSCs) for autologous stem-cell transplantation in patients with breast and ovarian cancer.

PATIENTS AND METHODS

PBSCs were collected from 17 patients with breast (n = 11), ovarian (n = 5), and gastric (n = 1) cancer after administration of Taxol (170 mg/m2 x 1) and CY (4 g/m2 x 1) followed by rhG-CSF (10 micrograms/kg/d). PBSC collections after Taxol and CY were compared with PBSC collections from nine patients with stage IV breast (n = 8) or stage III ovarian (n = 1) cancer who had received CY (4 g/m2 x 1) followed by rhG-CSF (16 micrograms/kg/d) for mobilization.

RESULTS

Mean WBC and platelet counts on the first day of apheresis were 6.3 x 10(9)/L (range, 1.9 to 22.1) and 35 x 10(9)/L (range, 19 to 77), respectively. The median numbers of CD34+ cells, peripheral-blood mononuclear cells (PBMNC), and peripheral-blood total nucleated cells (PBTNC) collected were 13.02 x 10(6)/kg (range, 5.4 to 57.8; mean, 16.02), 6.86 x 10(8)/kg (range, 1.9 to 51.2), and 17.41 x 10(8)/kg (range, 2.4 to 106.6), respectively. In the comparison group, the median yield of CD34+ cells was 6.39 x 10(6)/kg (range, 0.2 to 28; mean, 10.01; P = .01). The mean daily yield of CD34+ cells/kg/collection was 3.5 (range, 0.8 to 28.9) after Taxol and CY, as compared with 1.3 (range, 0.1 to 7.0) for patients who received CY alone (P = .01). All patients who received CY and Taxol reached a target level of 5 x 10(6) CD34+ cells/kg, as compared with five of nine patients (55.5%) who received CY alone (P = .03).

CONCLUSION

These data suggest that Taxol and CY followed by rhG-CSF mobilizes PBSCs in patients with advanced breast and ovarian cancer more effectively than this regimen without Taxol.

摘要

目的

在此，我们评估紫杉醇（泰素；百时美施贵宝公司，新泽西州普林斯顿）和环磷酰胺（CY）联合重组人粒细胞集落刺激因子（rhG-CSF）用于动员乳腺癌和卵巢癌患者的外周血干细胞（PBSC），以进行自体干细胞移植。

患者和方法

17例乳腺癌（n = 11）、卵巢癌（n = 5）和胃癌（n = 1）患者在接受紫杉醇（170 mg/m²×1）和CY（4 g/m²×1）后，再给予rhG-CSF（10微克/千克/天），之后采集PBSC。将紫杉醇和CY治疗后的PBSC采集情况与9例IV期乳腺癌（n = 8）或III期卵巢癌（n = 1）患者的PBSC采集情况进行比较，这些患者接受CY（4 g/m²×1）后再给予rhG-CSF（16微克/千克/天）以进行动员。

结果

采集第一天的平均白细胞计数和血小板计数分别为6.3×10⁹/L（范围1.9至22.1）和35×10⁹/L（范围19至77）。采集的CD34⁺细胞、外周血单个核细胞（PBMNC）和外周血总核细胞（PBTNC）的中位数分别为13.02×10⁶/千克（范围5.4至57.8；平均值16.02）、6.86×10⁸/千克（范围1.9至51.2）和17.41×10⁸/千克（范围2.4至106.6）。在比较组中，CD34⁺细胞的中位数产量为6.39×10⁶/千克（范围0.2至28；平均值10.01；P = 0.01）。紫杉醇和CY治疗后，每采集一次每千克CD34⁺细胞的平均日产量为3.5（范围0.8至28.9），而单独接受CY治疗的患者为1.3（范围0.1至7.0）（P = 0.01）。所有接受CY和紫杉醇治疗的患者均达到了5×10⁶ CD34⁺细胞/千克的目标水平，而单独接受CY治疗的9例患者中有5例（55.5%）达到该水平（P = 0.03）。