Cytoreduction of lymphoid malignancies and mobilization of blood hematopoietic progenitor cells with high doses of cyclophosphamide and etoposide plus filgrastim

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Lloyd DamonCharles Linker

Abstract

We evaluated the efficiency of high doses of cyclophosphamide (6 g/m2) and etoposide (2 g/m2) plus filgrastim (granulocyte colony-stimulating factor; G-CSF) to mobilize autologous hematopoietic progenitor cells in patients with non-Hodgkin lymphoma, multiple myeloma, and Waldenström macroglobulinemia. We also evaluated the safety of this regimen and the engraftment kinetics after myeloablative chemotherapy. Seventy-nine patients with high-risk or relapsed/primary refractory non-Hodgkin lymphoma, multiple myeloma, or Waldenström macroglobulinemia were treated. The mobilizing regimen was as follows: cyclophosphamide 600 mg/m2 twice daily for 10 doses, etoposide 200 mg/m2 twice daily for 10 doses (continuous; n=57) or 2 g/m2 over 10 hours on day 5 of etoposide (bolus; n=22), and G-CSF 5 microg/kg/d beginning day 14. Fifty-nine percent of patients achieved the primary end point (a CD34 cell dose of 5 million per kilogram with a single leukapheresis). More bolus etoposide patients achieved the primary end point (86%) compared with continuous etoposide patients (47%; P<.0001). The CD34 cell dose collected was greater in bolus etoposide patients (44 million per kilogram) than in continuous etoposide patients (10.9 million per kilogram...Continue Reading

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Citations

Nov 19, 2010·Expert Review of Hematology·Lloyd E Damon, Lauren E Damon
Apr 28, 2009·International Journal of Pediatric Otorhinolaryngology·Tao XueJun Chen
Jul 8, 2011·The Cochrane Database of Systematic Reviews·Renée L MulderLeontien Cm Kremer
Apr 16, 2019·The Cochrane Database of Systematic Reviews·Renée L MulderElvira C van Dalen

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