High-dose carboplatin chemotherapy with gmcsf and peripheral blood progenitor cell support: a model for delivering repeated cycles of dose-intensive therapy

Thomas C. Shea, James R. Mason, Anna Maria Storniolo, Eileen Bissent, Margaret Breslin, Michael Mullen, Raymond Taetle

Research output: Contribution to journalArticle

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Abstract

High-dose chemotherapy regimens can cure a number of otherwise incurable diseases, such as Hodgkin's disease, non-Hodgkin's lymphoma, neuroblastoma, acute leukemia (in remission), and breast cancer. Trials of high-dose chemotherapy have generally used autologous bone marrow transplant or peripheral blood stem cell support to ensure hematologic recovery after intensive chemotherapy and/or radiation. This report describes an approach in which high-dose carboplatin chemotherapy was followed initially by granulocyte-macrophage colony-stimulating factor (GM-CSF; Escherichia coli. Sandoz-Schering, East Hanover and Kenilworth, NJ) and in subsequent patients, by both GM-CSF and repeated cycles of peripheral blood progenitor cell (PBPC) collection and administration. The addition of PBPC to this regimen led to significant reductions in the duration of neutropenia and thrombocytopenia, the requirement for erythrocyte and platelet transfusions, the length of hospital stay, and the use of intravenous antibiotics in this group relative to those patients who received GM-CSF alone. In addition, laboratory studies are presented that show a direct correlation between the number of progenitor cells reinfused and the duration of neutropenia and thrombocytopenia. The report also reviews data indicating that circulating progenitor cells are depleted by this approach. This suggests that the number of progenitor cells available for mobilization is finite. Finally, the magnitude of these effects, and their implications for future trials with repetitive cycles of dose-intensive therapy, are discussed.

Original languageEnglish (US)
Pages (from-to)11-20
Number of pages10
JournalCancer Treatment Reviews
Volume19
Issue numberSUPPL. C
DOIs
StatePublished - Oct 1993

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Carboplatin
Blood Cells
Granulocyte-Macrophage Colony-Stimulating Factor
Stem Cells
Drug Therapy
Neutropenia
Thrombocytopenia
Length of Stay
Therapeutics
Erythrocyte Transfusion
Platelet Transfusion
Hodgkin Disease
Neuroblastoma
Non-Hodgkin's Lymphoma
Leukemia
Bone Marrow
Radiation
Breast Neoplasms
Escherichia coli
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

High-dose carboplatin chemotherapy with gmcsf and peripheral blood progenitor cell support : a model for delivering repeated cycles of dose-intensive therapy. / Shea, Thomas C.; Mason, James R.; Storniolo, Anna Maria; Bissent, Eileen; Breslin, Margaret; Mullen, Michael; Taetle, Raymond.

In: Cancer Treatment Reviews, Vol. 19, No. SUPPL. C, 10.1993, p. 11-20.

Research output: Contribution to journalArticle

Shea, Thomas C. ; Mason, James R. ; Storniolo, Anna Maria ; Bissent, Eileen ; Breslin, Margaret ; Mullen, Michael ; Taetle, Raymond. / High-dose carboplatin chemotherapy with gmcsf and peripheral blood progenitor cell support : a model for delivering repeated cycles of dose-intensive therapy. In: Cancer Treatment Reviews. 1993 ; Vol. 19, No. SUPPL. C. pp. 11-20.
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