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Mobilization of circulating progenitor cells in multiple myeloma during VCAD therapy with or without rhG-CSF.
- Source :
-
Haematologica [Haematologica] 1995 Mar-Apr; Vol. 80 (2), pp. 108-14. - Publication Year :
- 1995
-
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.<br />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.<br />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.<br />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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 0390-6078
- Volume :
- 80
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 7543068