Demirer T, Rowley S, Buckner C D, Appelbaum F R, Lilleby K, Storb R, Schiffman K, Bensinger W I
University of Washington School of Medicine, Fred Hutchinson Cancer Research Center, Seattle 98104, USA.
J Clin Oncol. 1995 Jul;13(7):1714-9. doi: 10.1200/JCO.1995.13.7.1714.
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.
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.
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).
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.
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。
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。
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）。
这些数据表明，对于晚期乳腺癌和卵巢癌患者，紫杉醇和CY联合rhG-CSF动员PBSC的效果比不使用紫杉醇的方案更有效。
