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Start Over Author "Vasta, S." Topic antineoplastic combined chemotherapy protocols
9 results on '"Vasta, S."'

1. Mobilization of circulating progenitor cells in multiple myeloma during VCAD therapy with or without rhG-CSF.

Author

Majolino I, Marcenò R, Buscemi F, Scimè R, Vasta S, Indovina A, Pampinella M, Catania P, and Santoro A

Subjects
Adult, Agranulocytosis chemically induced, Antineoplastic Combined Chemotherapy Protocols adverse effects, Bone Marrow Transplantation, Cyclophosphamide administration & dosage, Cyclophosphamide adverse effects, Dexamethasone administration & dosage, Dexamethasone adverse effects, Doxorubicin administration & dosage, Doxorubicin adverse effects, Female, Fever chemically induced, Graft Survival, Granulocyte Colony-Stimulating Factor pharmacology, Granulocyte Colony-Stimulating Factor therapeutic use, Humans, Male, Middle Aged, Multiple Myeloma blood, Multiple Myeloma pathology, Recombinant Proteins pharmacology, Recombinant Proteins therapeutic use, Treatment Outcome, Vincristine administration & dosage, Vincristine adverse effects, Agranulocytosis prevention & control, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation, Hematopoietic Stem Cells drug effects, Multiple Myeloma drug therapy
Abstract

Background: Circulating progenitor cells (CPC), when infused in large numbers, rapidly repopulate the marrow after myeloablation with high-dose therapy. In multiple myeloma (MM), as in other disorders, different chemotherapy regimens, including single-as well as multiple-agent chemotherapy, with or without hemopoietic growth factors, have been proposed to mobilize these progenitor cells into the blood. Here we report our experience with a drug combination called VCAD and compare the results to those obtained by adding rhG-CSF to the same combination., Methods: Fourteen MM patients were given one course of VCAD, a chemotherapy association of vincristine 2 mg, cyclophosphamide 4 x 0.5 g/m2, adriamycin 2 x 50 mg/m2 and dexamethasone 4 x 40 mg, before undergoing apheresis to collect CPC for autografting. Seven also received rhG-CSF (filgrastim) 5 mcg/kg/day over the period of apheresis. These latter were allocated to rhG-CSF treatment sequentially from the time the drug became available for clinical use., Results: Following VCAD-induced pancytopenia, CFU-GM peaked at a median of 853/mL (range 96-4352; 7.6 times basal level). RhG-CSF administration increased CFU-GM levels but not significantly. With rhG-CSF the CFU-GM peak was reached sooner, toxicity was reduced and granulocytopenia less protracted. Fewer aphereses were run in the rhG-CSF group, there were higher yields per single run, and patients began and completed their collection program more quickly., Conclusions: The VCAD association is able to mobilize CPC in patients with MM, and rhG-CSF is recommended as a fundamental part of the priming schedule.

Published
1995

2. High-dose cyclophosphamide, etoposide and BCNU (CVB) with autologous stem cell rescue in malignant lymphomas.

Author

Patti C, Majolino I, Scimè R, Indovina A, Vasta S, Liberti G, Gentile S, Santoro A, Pisa R, and Caronia F

Subjects
Adult, Carmustine administration & dosage, Colony-Forming Units Assay, Combined Modality Therapy, Cyclophosphamide administration & dosage, Etoposide administration & dosage, Female, Follow-Up Studies, Hodgkin Disease pathology, Hodgkin Disease therapy, Humans, Lymphoma pathology, Lymphoma, Non-Hodgkin pathology, Lymphoma, Non-Hodgkin therapy, Male, Middle Aged, Neoplasm Staging, Salvage Therapy, Time Factors, Transplantation, Autologous methods, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bone Marrow Transplantation methods, Lymphoma therapy, Stem Cell Transplantation
Abstract

Eighteen patients with malignant lymphoma, 10 non-Hodgkin's and 8 Hodgkin's, were treated with high-dose CVB (cyclophosphamide 4 x 1.5 g/m2, etoposide 4 x 250-400 mg/m2, carmustine 4 x 150-200 mg/m2), followed by autologous peripheral blood stem cells (PBSC, 13 patients) or bone marrow (BM, 5 patients) transplantation. At the time of autograft 6 patients were in complete remission (CR), 3 in partial remission (PR) and 5 in relapse (4 sensitive, 1 resistant), whereas 4 had progressive disease. All CR patients had poor prognostic features at presentation. PBSC were collected at the time of rapid hematologic recovery after intense chemotherapy by means of a cell separator. All patients engrafted. Median time to achieve > or = 0.5 x 10(9)/l polymorphonuclear cells (PMN) and > or = 50 x 10(9)/l platelets was 13 days for both cell types in PBSC autografted patients, versus 20 and 28 days respectively in BM autografted patients. A significant advantage of PBSC over BM was found in terms of time needed to recover either PMN > or = 0.5 and PMN > or = 1 x 10(9)/l (p = 0.01). Autograft-related toxicity consisted mainly of moderate severity interstitial pneumopathy (3 patients), and veno-occlusive disease (1 patient) that resolved completely. Of the 12 patients autografted with detectable disease, 6 (50%) obtained a CR. Seven out of 18 autografted patients (39%) had disease progression within 1 to 5 months of autograft. The projected progression-free survival is over 50% at 4 years and it was significantly longer in patients with sensitive disease than in those with resistant disease (p = 0.01). The efficacy and the low toxicity of CVB suggest that autograft with PBSC may be proposed for the primary treatment of poor prognosis malignant lymphomas.

Published
1993
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3. High-dose therapy and autologous transplantation in amyloidosis-AL.

Author

Majolino I, Marcenò R, Pecoraro G, Scimé R, Vasta S, Liberti G, Rizzo A, Indovina A, and Caronia F

Subjects
Amyloidosis drug therapy, Amyloidosis etiology, Busulfan administration & dosage, Combined Modality Therapy, Dexamethasone, Doxorubicin administration & dosage, Female, Humans, Melphalan administration & dosage, Middle Aged, Paraproteinemias complications, Paraproteinemias drug therapy, Pulmonary Fibrosis complications, Vincristine administration & dosage, Amyloidosis therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Blood Transfusion, Autologous, Hematopoietic Stem Cell Transplantation, Paraproteinemias therapy
Abstract

A 53-yr.-old woman with amyloidosis AL was treated with high-dose chemotherapy and autologous stem cell infusion in an attempt to suppress the amyloid secretion. A diagnosis of MGUS had been made six years earlier. During the last year her disease had progressively shifted to a full-blown picture of amyloidosis AL, with renal failure, proteinuria, renal amyloid deposition and plasma cell sheets in the marrow. After an unsuccessful attempt with standard-dose chemotherapy, she received a high-dose regimen of busulphan (14 mg/Kg) and melphalan (40 mg/m2), followed by the infusion of both autologous bone marrow and peripheral blood stem cells. She had full and prompt engraftment, but eight weeks post-graft developed interstitial pneumonitis: CMV was isolated. The patient died while in the intensive care unit. In the literature, this is the first case of amyloidosis AL treated with high-dose therapy and autologous transplantation.

Published
1993

4. Treatment of malignant lymphomas with very-high-dose CVB followed by transplantation of autologous blood stem cells collected after mobilizing chemotherapy.

Author

Majolino I, Scimè R, Indovina A, Vasta S, Patti C, Gentile S, Santoro A, Di Noto R, Fabbiano F, and Guarnaccia C

Subjects
Adult, Antineoplastic Combined Chemotherapy Protocols adverse effects, Bleomycin administration & dosage, Bleomycin adverse effects, Bone Marrow drug effects, Bone Marrow pathology, Cisplatin administration & dosage, Cisplatin adverse effects, Combined Modality Therapy, Cyclophosphamide pharmacology, Etoposide pharmacology, Humans, Leukapheresis, Lymphoma therapy, Middle Aged, Pancytopenia chemically induced, Pancytopenia therapy, Pulmonary Fibrosis etiology, Radiotherapy adverse effects, Remission Induction, Transplantation, Autologous, Vindesine administration & dosage, Vindesine adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation, Lymphoma drug therapy
Abstract

In 8 patients (age 25 +/- 46 years, mean 34.5), 4 with Hodgkin's disease (HD) and 4 with non-Hodgkin's lymphoma (NHL), circulating stem cells (CSC) collected at the time of rapid leukocyte and platelet recovery after intense chemotherapy were employed for autologous hematological reconstitution after very-high-dose chemotherapy (CVB combination). At the time of graft 2 patients were in 1st remission and 2 in 2nd, while the remaining 4 had persistence or progression of disease. Autografted patients received 3.4 +/- 8.3 (mean 5.2) x 10e8/Kg mononuclear cells and 2.1 +/- 40.5 (mean 22.5) x 10e4/Kg CFU-GM. All patients had prompt and sustained engraftment, though in one case platelets never reached normal levels. Recovery time was respectively 10 +/- 17 days (mean 13.2) for granulocytes 0.5 x 10e9/L, and 10 +/- 49 days (mean 20.3) for platelets greater than 50.0 x 10e9/L, with an interval of less than 4 days from greater than 0.5 to greater than 1.0 granulocytes in 7 out of the 8 patients. All patients are currently alive at 57 +/- 645 (median 262) days, and 7 in remission at 61 +/- 645 (median 297) days from autologous blood stem cell transplantation (ABSCT). Our study demonstrates that CSC collected after mobilizing chemotherapy are able to promptly restore and sustain hemopoiesis after marrow ablative chemotherapy in patients with malignant lymphoma. CSC reduce toxicity and hospitalization so impressive, that in malignant lymphomas ABSCT could rapidly be considered for first line strategy.

Published
1991

6. High-dose cyclophosphamide, etoposide and BCNU (CVB) with autologous stem cell rescue in malignant lymphomas

Author

C. Patti, A Indovina, R. Pisa, Ignazio Majolino, Vasta S, Caronia F, G. Liberti, Alessandra Santoro, Rosanna Scimè, and S. Gentile

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Time Factors, Lymphoma, Cyclophosphamide, medicine.medical_treatment, Transplantation, Autologous, Gastroenterology, Colony-Forming Units Assay, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Autologous transplantation, Etoposide, Bone Marrow Transplantation, Neoplasm Staging, Salvage Therapy, Carmustine, Chemotherapy, business.industry, Lymphoma, Non-Hodgkin, Hematology, General Medicine, Middle Aged, medicine.disease, Combined Modality Therapy, Hodgkin Disease, Transplantation, medicine.anatomical_structure, Female, Bone marrow, business, Progressive disease, Follow-Up Studies, Stem Cell Transplantation, medicine.drug
Abstract

Eighteen patients with malignant lymphoma, 10 non-Hodgkin's and 8 Hodgkin's, were treated with high-dose CVB (cyclophosphamide 4 x 1.5 g/m2, etoposide 4 x 250-400 mg/m2, carmustine 4 x 150-200 mg/m2), followed by autologous peripheral blood stem cells (PBSC, 13 patients) or bone marrow (BM, 5 patients) transplantation. At the time of autograft 6 patients were in complete remission (CR), 3 in partial remission (PR) and 5 in relapse (4 sensitive, 1 resistant), whereas 4 had progressive disease. All CR patients had poor prognostic features at presentation. PBSC were collected at the time of rapid hematologic recovery after intense chemotherapy by means of a cell separator. All patients engrafted. Median time to achieve > or = 0.5 x 10(9)/l polymorphonuclear cells (PMN) and > or = 50 x 10(9)/l platelets was 13 days for both cell types in PBSC autografted patients, versus 20 and 28 days respectively in BM autografted patients. A significant advantage of PBSC over BM was found in terms of time needed to recover either PMN > or = 0.5 and PMN > or = 1 x 10(9)/l (p = 0.01). Autograft-related toxicity consisted mainly of moderate severity interstitial pneumopathy (3 patients), and veno-occlusive disease (1 patient) that resolved completely. Of the 12 patients autografted with detectable disease, 6 (50%) obtained a CR. Seven out of 18 autografted patients (39%) had disease progression within 1 to 5 months of autograft. The projected progression-free survival is over 50% at 4 years and it was significantly longer in patients with sensitive disease than in those with resistant disease (p = 0.01). The efficacy and the low toxicity of CVB suggest that autograft with PBSC may be proposed for the primary treatment of poor prognosis malignant lymphomas.

Published
2009

7. Engraftment kinetics and long-term stability of hematopoiesis following autografting of peripheral blood stem cells

Author

Indovina A, Majolino I, Filippo Buscemi, Scimè R, Vasta S, Santoro A, Pampinella M, Catania P, and Caronia F

Subjects
Adult, Male, Adolescent, Graft Survival, Hematopoietic Stem Cell Transplantation, Middle Aged, Hematopoiesis, Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Child, Bone Marrow Diseases, Bone Marrow Transplantation, Retrospective Studies
Abstract

We analyzed short-term and sustained hematopoietic reconstitution after high-dose therapy with peripheral blood stem cell (PBSC) support in patients with various malignant disorders.Fifty-six patients, all with malignant hematologic disorders, were autografted between 1989 and 1994 using PBSC (47 pts) or PBSC + bone marrow (BM) cells (9 pts). PBSC were collected after mobilization with chemotherapy +/- hematopoietic growth factors (GF).All patients engrafted0.5 x 10(9)/L polymorphonuclear cells (PMN) and50.0 x 10(9)/L Plt at a median of 12 (8-32) and 13 (9-365) days, respectively. Thirty-nine patients were evaluable for long-term graft performance, and their hematologic values at 30 and 100 days, at 6 months and at 1, 2, 3, 4 and 5 years were retrospectively analyzed. Steady counts were recorded over the years. None of the patients had late graft failure.PBSC given after high-dose chemotherapy ensure a fast hematologic recovery with stable graft performance up to five years after autograft. Though this is not definitive proof of the presence of uncommitted stem cells in the PBSC population, it gives further support to the idea that PBSC are as safe as bone marrow for long-term engraftment. A delayed or incomplete recovery of platelets may occur with low PBSC counts or when disease relapse occurs rapidly after autograft.

Published
1995

8. High dose cyclophosphamide: stem cell mobilizing capacity in 21 patients

Author

Rosanna Scimè, Alessandra Santoro, Caronia F, Serena Gentile, Vasta S, Indovina A, Grace Liberti, Maria Pampinella, and Ignazio Majolino

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Cyclophosphamide, Adolescent, Nausea, medicine.medical_treatment, Hematopoietic stem cell transplantation, Gastroenterology, Neuroblastoma, Internal medicine, Neoplasms, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, business.industry, Hematopoietic Stem Cell Transplantation, Granulocyte-Macrophage Colony-Stimulating Factor, Hematology, Middle Aged, medicine.disease, Hematopoietic Stem Cells, Combined Modality Therapy, Recombinant Proteins, Surgery, Blood Cell Count, Transplantation, Treatment Outcome, Oncology, Toxicity, Vomiting, Female, Stem cell, medicine.symptom, business, medicine.drug
Abstract

In the present study we assess the antitumor effect and circulating stem cells (CSC) mobilizing capacity of high-dose cyclophosphamide (5 to 7 gr/m2, HDCY). This treatment was given to 21 patients with various hematologic malignancies (8 NHL, 5 MM, 4 HD, 3 CML) excluding 1 with neuroblastoma. All were eligible for later autologous blood stem cell transplantation (ABSCT). To reduce the hematologic toxicity of HDCY, GM CSF was simultaneously administered in 5 patients. HDCY produced a response (as defined by a > 50% reduction of previous tumor mass) in 3 out of 12 HD/NHL and 1 out of 3 MM. Patients with CML were not considered to be evaluable for tumor response. Cell collection yields after HDCY varied widely with a range of 1.5 to 169.9 x 10(4)/Kg (median 13.1) CFU-GM and 1.7 to 18.4 x 10(8)/Kg (median 5.8) MNC collected per patient. Hematologic recovery was rapid and sustained with a median of 16 (12-18) days to PMN > 0.5 x 10(9)/L and 14 (11-18) days to Plt > 100.0 x 10(9)/L. Granulocyte recovery was significantly faster after GM-CSF (13 vs 16 days to PMN > 0.5, p = 0.0008). Non hematologic toxicity consisted mainly of nausea and vomiting, but fatal complications occurred in 2 patients, from pulmonary infection in one and from tumor-lysis syndrome in the other. HDCY represents a useful means of increasing collection of CSC, but toxicity is not irrelevant. Whether a similar anti-tumor effect and mobilizing capacity would be offered by single lower intermediate doses of the drug is still to be ascertained.

Published
1994

9. Treatment of malignant lymphomas with very-high-dose CVB followed by transplantation of autologous blood stem cells collected after mobilizing chemotherapy

Author

I, Majolino, R, Scimè, A, Indovina, S, Vasta, C, Patti, S, Gentile, A, Santoro, R, Di Noto, F, Fabbiano, C, Guarnaccia, Majolino, I., Scimè, R., Indovina, A., Vasta, S., Patti, C., Gentile, S., Santoro, A., DI NOTO, Rosa, Fabbiano, F., and Guarnaccia, C.

Subjects
Adult, Lymphoma, Radiotherapy, Vindesine, Pancytopenia, Pulmonary Fibrosis, Remission Induction, Hematopoietic Stem Cell Transplantation, Middle Aged, Combined Modality Therapy, Transplantation, Autologous, Bleomycin, Bone Marrow, Antineoplastic Combined Chemotherapy Protocols, Humans, Leukapheresis, Cisplatin, Cyclophosphamide, Etoposide
Abstract

In 8 patients (age 25 +/- 46 years, mean 34.5), 4 with Hodgkin's disease (HD) and 4 with non-Hodgkin's lymphoma (NHL), circulating stem cells (CSC) collected at the time of rapid leukocyte and platelet recovery after intense chemotherapy were employed for autologous hematological reconstitution after very-high-dose chemotherapy (CVB combination). At the time of graft 2 patients were in 1st remission and 2 in 2nd, while the remaining 4 had persistence or progression of disease. Autografted patients received 3.4 +/- 8.3 (mean 5.2) x 10e8/Kg mononuclear cells and 2.1 +/- 40.5 (mean 22.5) x 10e4/Kg CFU-GM. All patients had prompt and sustained engraftment, though in one case platelets never reached normal levels. Recovery time was respectively 10 +/- 17 days (mean 13.2) for granulocytes 0.5 x 10e9/L, and 10 +/- 49 days (mean 20.3) for platelets greater than 50.0 x 10e9/L, with an interval of less than 4 days from greater than 0.5 to greater than 1.0 granulocytes in 7 out of the 8 patients. All patients are currently alive at 57 +/- 645 (median 262) days, and 7 in remission at 61 +/- 645 (median 297) days from autologous blood stem cell transplantation (ABSCT). Our study demonstrates that CSC collected after mobilizing chemotherapy are able to promptly restore and sustain hemopoiesis after marrow ablative chemotherapy in patients with malignant lymphoma. CSC reduce toxicity and hospitalization so impressive, that in malignant lymphomas ABSCT could rapidly be considered for first line strategy.

Published
1991

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