Copelan E A, Ceselski S K, Ezzone S A, Lasky L C, Penza S L, Bechtel T P, Klein J L, Hehmeyer D M, Scholl M D, Marshall D D, Elder P J, Risley G L, Avalos B R
Department of Internal Medicine, The Ohio State University, Columbus 43210, USA.
J Clin Oncol. 1997 Feb;15(2):759-65. doi: 10.1200/JCO.1997.15.2.759.
We analyzed the safety and effectiveness of high-dose etoposide (2 g/m2) followed by granulocyte colony-stimulating factor (G-CSF) as a peripheral-blood progenitor cell (PBPC) mobilization regimen and assessed extent of tumor reduction in patients with breast cancer, non-Hodgkin's lymphoma (NHL), and Hodgkin's disease (HD).
One hundred sixty-nine consecutive patients who eventually underwent PBPC transplantation received treatment with high-dose etoposide (2 g/m2) followed by daily G-CSF (5 microg/kg).
This mobilization method was effective in nearly all patients. No patients died of mobilization-related complications. A 50% reduction in tumor size was seen in 19% of assessable patients with breast cancer, 44% of those with NHL, and 38% of those with HD. Hematopoietic recovery (HR) following transplantation occurred in all patients. Patients with > or = 4 x 10(6) CD34+ cells/kg engrafted with neutrophils at a median of 9 days after transplant and patients with at least 1.2 x 10(6) CD34+/CD33- cells/kg achieved platelet recovery at a median of 15 days.
Etoposide plus G-CSF is an effective and safe method for mobilization of PBPCs. Etoposide is an effective agent in tumor reduction in NHL and HD and is less effective in breast cancer. The substantially lower incidence of prior exposure to this agent compared with cyclophosphamide favors its use.
我们分析了大剂量依托泊苷（2 g/m²）联合粒细胞集落刺激因子（G-CSF）作为外周血祖细胞（PBPC）动员方案的安全性和有效性，并评估了乳腺癌、非霍奇金淋巴瘤（NHL）和霍奇金病（HD）患者的肿瘤缩小程度。
169例最终接受PBPC移植的连续患者接受了大剂量依托泊苷（2 g/m²）治疗，随后每日给予G-CSF（5 μg/kg）。
这种动员方法在几乎所有患者中均有效。没有患者死于与动员相关的并发症。在可评估的乳腺癌患者中，19%出现肿瘤大小缩小50%；NHL患者中为44%；HD患者中为38%。所有患者移植后造血功能均恢复。移植后，每千克体重有≥4×10⁶个CD34⁺细胞的患者，中性粒细胞在移植后中位9天植入；每千克体重至少有1.2×10⁶个CD34⁺/CD33⁻细胞的患者，血小板在移植后中位15天恢复。
依托泊苷联合G-CSF是一种有效且安全的PBPC动员方法。依托泊苷是NHL和HD中有效的肿瘤缩小药物，在乳腺癌中效果较差。与环磷酰胺相比该药物先前暴露的发生率显著更低，这有利于其使用。
