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Phase III randomized study comparing 5 or 10 microg per kg per day of filgrastim for mobilization of peripheral blood progenitor cells with chemotherapy, followed by intensification and autologous transplantation in patients with nonmyeloid malignancies
- Source :
- Transfusion, Vol. 43, no. 1, p. 50-7 (2003)
- Publication Year :
- 2003
-
Abstract
- BACKGROUND: It is not known whether increasing the dose of filgrastim after mobilizing chemotherapy improves collection of peripheral blood progenitor cells (PBPC) and leads to faster hematopoietic engraftment after autologous transplantation. STUDY DESIGN AND METHODS: A randomized, open-label, multicenter trial was carried out in patients with breast cancer, multiple myeloma, and lymphoma, in which patients were randomized to receive 5 or 10 microg per kg per day of filgrastim after standard chemotherapy to mobilize PBPCs. After high-dose chemotherapy, the components from the first two leukapheresis procedures were returned, and all patients received 5 microg per kg day of filgrastim after transplantation. RESULTS: A total of 131 patients were randomized, of whom 128 were mobilized (Group A, 5 microg/kg, n = 66; Group B, 10 microg/kg, n = 62) and 112 were transplanted. Only six patients were not transplanted because of insufficient CD34+ cell numbers. The median number of CD34+ cells collected in the first two leukapheresis procedures tended to be higher in Group B than in Group A (12.0 vs. 7.2 x 10(6)/kg, NS), but after transplantation there was no significant difference in median times to platelet (9 days in both groups) or neutrophil (8 days in both groups) engraftment or the number of platelet transfusions (three in both groups). A subsequent subgroup analysis separating patients transplanted after first- or second-line chemotherapy also showed no measurable impact of filgrastim dose on the median CD34+ cell yield or on platelet engraftment in either subgroup. CONCLUSION: PBPC mobilization with chemotherapy and 5 microg per kg of filgrastim is very efficient, and 10 microg per kg of filgrastim does not provide additional clinical benefit.
- Subjects :
- Adult
Male
medicine.medical_specialty
Platelet Engraftment
Filgrastim
Lymphoma
medicine.medical_treatment
Immunology
Urology
Antineoplastic Agents
Breast Neoplasms
Transplantation, Autologous
Multicenter trial
Granulocyte Colony-Stimulating Factor
medicine
Immunology and Allergy
Autologous transplantation
Humans
Leukapheresis
Aged
Chemotherapy
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Hematopoietic Stem Cell Mobilization
Recombinant Proteins
Surgery
Granulocyte colony-stimulating factor
Transplantation
Female
business
Multiple Myeloma
medicine.drug
Subjects
Details
- ISSN :
- 00411132
- Volume :
- 43
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Transfusion
- Accession number :
- edsair.doi.dedup.....a8e26d2c8fc426a5c0d8de519a9fe665