Journal article
Factors Influencing Mobilization and Engraftment in Patients with Metastatic Breast Cancer Undergoing PBSC Transplantation
Journal of hematotherapy, Vol.8(2), pp.167-172
04/01/1999
DOI: 10.1089/106161299320433
PMID: 10349910
Abstract
Factors influencing mobilization and engraftment of PBSC were analyzed in 38 patients with metastatic breast cancer who were undergoing PBSC transplantation. None of these patients had had previous chemotherapy
for metastatic disease. PBSC were mobilized with cyclophosphamide (CY) and G-CSF (n = 21) or CY and etoposide (CY-etoposide) and G-CSF (n = 17). All received cyclophosphamide 6000 mg/m2, thiotepa 500 mg/m2,
and carboplatin 800 mg/m2 (CTCb) as preparative regimen. PBSC infusion was followed by G-CSF at 5 mu g/kg in 30 patients or 10 mu g/kg in 8 patients. A median number of 27 X 10 6 CD34+ cells/kg was obtained
with a median of four aphereses. Previous chemotherapy, radiation therapy, marrow disease, time from previous chemotherapy to mobilization, and type of mobilization regimen did not have a statistically
significant effect on collection efficiency (CE). CE was defined as the total number of CD34+ collected/number of collections. Engraftment was rapid, with patients reaching a neutrophil count of 0.5 X 10
9/L a median of 9 days (range 7-23) and a platelet count of 20 X 10 9/L a median of 12 days (range 8-28) after transplantation. Shorter times to platelet recovery were associated with a higher number of
CD34+ cells infused (p = 0.012), CY mobilization (p = 0.033), and a lower number of prior chemotherapy cycles (p = 0.022). When the number of CD34+ cells was included in the proportional hazard model, no
other variables were found to be significant predictors of platelet engraftment. Time to neutrophil recovery was negatively associated with the dose of G-CSF used after transplantation (p = 0.036) CD34
cell dose is an important predictor of engraftment kinetics. A posttransplant dose of G-CSF improves neutrophil recovery. For patients with metastatic breast cancer and no previous chemotherapy for metastatic
disease, we have no evidence for a difference between CY and CY-Etoposide as the mobilization regimen.
Details
- Title: Subtitle
- Factors Influencing Mobilization and Engraftment in Patients with Metastatic Breast Cancer Undergoing PBSC Transplantation
- Creators
- Margarida De Magalhaes-SilvermanAlbert D DonnenbergJohn ListerWitold RybkaJohn WilsonEdward Ball
- Resource Type
- Journal article
- Publication Details
- Journal of hematotherapy, Vol.8(2), pp.167-172
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/106161299320433
- PMID
- 10349910
- ISSN
- 1061-6128
- eISSN
- 2168-6556
- Language
- English
- Date published
- 04/01/1999
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984094379802771
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