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Autografting

Multiple cycles of PBPC-supported high-dose carboplatin and paclitaxel following mobilization with epirubicin and cisplatin are feasible but ineffective in treating patients with advanced non-small cell lung cancer

Bone Marrow Transplantation volume 40, pages 735–739 (2007)Cite this article

Abstract

We verified the feasibility of a multi-cycle peripheral blood progenitor cell (PBPC)-supported high-dose chemotherapy (HDC) regimen in patients with non-small cell lung cancer (NSCLC). The HDC regimen consisted of a single course of high-dose epirubicin given in combination with cisplatin plus filgrastim, followed by three courses of high doses of carboplatin and paclitaxel with PBPC reinfusion and filgrastim. Of the 16 enrolled patients, 13 provided an adequate number of PBPCs by a single leukapheresis, while in the three needed two procedures, with a median number of CD34+, CD34+/CD33− and CD34+/CD38− cells collected per patient was 13.5 × 106, 10.9 × 106 and 0.9 × 106/kg, respectively. No toxic death occurred, and the collected PBPCs supported a rapid hematopoietic reconstitution after HDC; however, seven patients early interrupted the treatment early due to early progressive disease (n=4) or prolonged grade 3 peripheral neurotoxicity (n=3). Despite an overall response rate of 42%, the median survival for stage IV patients has been 5 months (range: 1–25+). Of two patients with stage IIIB NSCLC, one is continuously disease-free at 71+ months, while of 14 with stage IV disease, one is currently alive with disease at 25+ months. In conclusion, the combination of high-dose epirubicin with cisplatin plus filgrastim is an effective regimen in releasing large amounts of PBPCs, which can then be safely employed to support multiple courses of HDC. Multiple cycles of PBPC-supported high-dose carboplatin and paclitaxel are ineffective in treating patients with advanced NSCLC.

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Authors and Affiliations

  1. Istituto Oncologico Romagnolo-Department of Oncology and Hematology, Santa Maria delle Croci Hospital, Ravenna, Italy

    U De Giorgi, G Rosti, B Kopf & M Marangolo

  2. Neurology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy

    G Ciucci

  3. Department of Clinical Pathology, Santa Maria delle Croci Hospital, Ravenna, Italy

    C Minzi

  4. Blood Bank, Santa Maria delle Croci Hospital, Ravenna, Italy

    M Argnani

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  1. U De Giorgi
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  7. M Marangolo
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Correspondence to U De Giorgi.

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De Giorgi, U., Rosti, G., Ciucci, G. et al. Multiple cycles of PBPC-supported high-dose carboplatin and paclitaxel following mobilization with epirubicin and cisplatin are feasible but ineffective in treating patients with advanced non-small cell lung cancer. Bone Marrow Transplant 40, 735–739 (2007). https://doi.org/10.1038/sj.bmt.1705793

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