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Rowley SD, Donato ML, Bhattacharyya P. Red blood cell-incompatible allogeneic hematopoietic progenitor cell transplantation. Bone Marrow Transplant 2011; 46:1167-85. [DOI: 10.1038/bmt.2011.135] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Iqbal A, Motiwala T, Badin S, Rowley SD, Donato ML, Siegel DS, Lendvai N, Hamarman S, Pecora AL, Goldberg SL. Delayed daily filgrastim compared to early alternate day filgrastim following autologous peripheral blood stem cell transplantation for multiple myeloma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.18015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ueno NT, Konoplev S, Buchholz TA, Smith T, Rondón G, Anderlini P, Giralt SA, Gajewski JL, Donato ML, Cristofanilli M, Champlin RE. High-dose chemotherapy and autologous peripheral blood stem cell transplantation for primary breast cancer refractory to neoadjuvant chemotherapy. Bone Marrow Transplant 2006; 37:929-35. [PMID: 16565737 DOI: 10.1038/sj.bmt.1705355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of high-dose chemotherapy (HDCT) in patients with refractory breast cancer is not well established. Forty-two female patients (median age of 46 years) with breast cancer refractory to neoadjuvant chemotherapy received HDCT (cyclophosphamide, carmustine and thiotepa) supported by an autologous peripheral blood stem cells transplant. Their disease had been refractory (defined as less than partial response) to one (18 patients) or two (24 patients) regimens of neoadjuvant chemotherapy. Twenty-nine patients had surgery before HDCT. The best response after surgery, HDCT, and radiation therapy was assessed 60 days after transplantation. Thirty patients had complete remission, eight had a PR, one had a minor response, and three had progressive disease. In seven of 13 patients whose disease was inoperable before HDCT, it became operable. After a median follow-up of 42 months, 21 patients were alive, and 15 remained disease free. Five-year overall survival (OS) was 57% (CI, 50-64%), and the estimated 5-year progression-free survival was 40% (CI, 32-48%). Both OS and PFS were better in patients whose disease became operable after chemotherapy than in those whose disease remained inoperable. A randomized study is warranted in this patient population.
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Affiliation(s)
- N T Ueno
- Department of Blood and Marrow Transplantation, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
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Bodurka DC, Sun CC, Weaver CB, Bethancourt DL, Fitzgerald MA, Wolf JK, Gershenson DM, Kavanagh JJ, Munsell MF, Donato ML. Longitudinal assessment of quality of life (QOL) of patients (pts) with ovarian cancer (ovca) receiving high-dose or conventional-dose chemotherapy (CDCT). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - C. C. Sun
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | - J. K. Wolf
- UT M. D. Anderson Cancer Ctr, Houston, TX
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Sun CC, Bodurka DC, Weaver CB, Bethancourt DL, Fitzgerald MA, Wolf JK, Gershenson DM, Kavanagh JJ, Munsell MF, Donato ML. Preferences (PREFs) over time of chemo-experienced versus chemo-naïve patients (pts) for treatment-related side effects (SEs). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. C. Sun
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | | | - J. K. Wolf
- UT M. D. Anderson Cancer Ctr, Houston, TX
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Donato ML, Aleman A, Champlin RE, Saliba RM, Wharton JT, Burke TW, Bodurka DC, Bevers MW, Levenback CF, Wolf JK, Bast RC, Freedman RS, Ippoliti C, Brewer M, Gajewski JL, Gershenson DM. Analysis of 96 patients with advanced ovarian carcinoma treated with high-dose chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant 2005; 33:1219-24. [PMID: 15122311 DOI: 10.1038/sj.bmt.1704473] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to identify characteristics significant to survival and progression-free survival in patients with advanced ovarian cancer receiving high-dose chemotherapy. In all, 96 patients received autologous stem cell transplantation. Regimens included paclitaxel with carboplatin (PC), topotecan, melphalan, cyclophosphamide (TMC) and cyclophosphamide, BCNU, thiotepa (CBT). At the time of transplantation, 43% of patients were in clinical CR, 34% were in clinical PR, 18% had progressive disease and 5% had stable disease. There were no treatment-related deaths. The 6-year survival by Kaplan-Meier was 38%. For patients who received transplantation for remission consolidation, the 6-year survival was 53% with a PFS of 29%. On univariate analysis, the CBT regimen, clear cell histology and disease status other than CR prior to treatment were statistically significant adverse prognostic factors. This analysis has demonstrated that patients in clinical remission are most likely to benefit from autologous transplantation, with the exception of patients with clear cell histology. The TMC combination appeared to be superior to the PC and CBT combinations. Comparative studies of different consolidation approaches will be necessary to determine if autologous transplantation is the preferred treatment for this patient population.
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Affiliation(s)
- M L Donato
- Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Anderlini P, Acholonu SA, Okoroji GJ, Andersson BS, Couriel DR, De Lima MJ, Donato ML, Khouri IF, Giralt SA, Ueno NT, Champlin RE. Donor leukocyte infusions in relapsed Hodgkin's lymphoma following allogeneic stem cell transplantation: CD3+ cell dose, GVHD and disease response. Bone Marrow Transplant 2004; 34:511-4. [PMID: 15273710 DOI: 10.1038/sj.bmt.1704621] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nine patients with advanced Hodgkin's lymphoma (HL) who had undergone allogeneic stem cell transplantation (allo-SCT) received donor leukocyte infusions (DLIs) for treatment of persistent or progressive disease (PD). A total of 15 DLIs were performed, with four patients receiving more than one DLI. In four patients, prior salvage chemotherapy was administered. The median CD3+ cell dose administered was 77.5 x 10(6)/kg (range 5-285). GVHD developed in all but one patient. The response rate was 4/9 (44%). Three of these four responders developed GVHD and 3/4 had received chemotherapy. No correlation was observed between CD3+ cell dose infused and disease response. At the latest follow-up, three patients are alive and six have expired (PD n=3, nonrelapse mortality n=3). The median response duration was 7 months (range 4-9), with one response currently ongoing. These data suggest that DLIs for immunotherapy of recurrent HL have significant activity, although they frequently leads to GVHD. The small sample size does not allow any conclusion as to whether chemotherapy administration increases the chance of response. The CD3 cell dose infused does not seem to correlate with disease response.
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Affiliation(s)
- P Anderlini
- Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Gajewski JL, Ippoliti C, Giralt SA, Jones R, McMannis J, Shpall E, Khouri I, Hosing C, Champlin RE, Donato ML. Use of intensive antibiotic prophylaxis and a chemotherapy only T-cell depleted preparative regimen (prep reg) as a pilot study in haploidentical (haplo) transplant (tp) for treatment of pts with advanced leukemia. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. L. Gajewski
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. Ippoliti
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - S. A. Giralt
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - R. Jones
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - J. McMannis
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - E. Shpall
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - I. Khouri
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. Hosing
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - R. E. Champlin
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. L. Donato
- University of Texas M. D. Anderson Cancer Center, Houston, TX
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Sun CC, Donato ML, Wolf JK, Weaver CB, Fitzgerald MA, Gershenson DM, Bodurka DC. Preferences (PREF) over time of patients (pts) with ovarian cancer (OVCA) receiving conventional dose platinum-based chemotherapy (CDCT). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C. C. Sun
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. L. Donato
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - J. K. Wolf
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. B. Weaver
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. A. Fitzgerald
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. M. Gershenson
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. C. Bodurka
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
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Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood 2001; 98:3595-9. [PMID: 11739162 DOI: 10.1182/blood.v98.13.3595] [Citation(s) in RCA: 292] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This study investigated the use of a nonablative conditioning regimen to decrease toxicity and achieve engraftment of an allogeneic blood stem cell transplant, allowing a graft-versus-malignancy effect to occur. All patients had follicular or small cell lymphocytic lymphoma after relapse from a prior response to conventional chemotherapy. Patients received a preparative regimen of fludarabine (25 mg/m(2) given daily for 5 days or 30 mg/m(2) daily for 3 days) and intravenous cyclophosphamide (1 g/m(2) given daily for 2 days or 750 mg/m(2) daily for 3 days). Nine patients received rituximab in addition to the chemotherapy. Tacrolimus and methotrexate were used for graft-versus-host disease (GVHD) prophylaxis. Twenty patients were studied; their median age was 51 years. Twelve were in complete remission (CR) at transplantation. All patients achieved engraftment of donor cells. The median number of days with severe neutropenia was 6. Only 2 patients required more than one platelet transfusion. The cumulative incidence of acute grade II to IV GVHD was 20%. Only one patient developed acute GVHD of greater than grade II. All patients achieved CR. None have had a relapse of disease, with a median follow-up period of 21 months. The actuarial probability of being alive and in remission at 2 years was 84% (95% confidence interval, 57%-94%). Nonablative chemotherapy with fludarabine/cyclophosphamide followed by allogeneic stem cell transplantation is a promising therapy for indolent lymphoma with minimal toxicity and myelosuppression. Further studies are warranted to compare nonablative allogeneic hematopoietic transplantation with alternative treatment strategies.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Cyclophosphamide/administration & dosage
- Female
- Graft Survival
- Graft vs Host Disease/epidemiology
- Graft vs Host Disease/prevention & control
- Graft vs Tumor Effect
- Hematopoietic Stem Cell Transplantation
- Humans
- Immunosuppressive Agents/administration & dosage
- Immunotherapy, Adoptive
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/therapy
- Male
- Methotrexate/therapeutic use
- Middle Aged
- Platelet Transfusion
- Recurrence
- Remission Induction
- Rituximab
- Tacrolimus/therapeutic use
- Transplantation Conditioning/methods
- Transplantation, Homologous
- Treatment Outcome
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- I F Khouri
- Department of Blood and Marrow Transplantation, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Donato ML, Gershenson DM, Wharton JT, Ippoliti CM, Aleman AS, Bodurka-Bevers D, Bevers MW, Burke TW, Levenback CF, Wolf JK, Freedman RS, Bast RC, Gajewski JL, Champlin RE. High-dose topotecan, melphalan, and cyclophosphamide (TMC) with stem cell support: a new regimen for the treatment of advanced ovarian cancer. Gynecol Oncol 2001; 82:420-6. [PMID: 11520135 DOI: 10.1006/gyno.2001.6326] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The goal of this study was to determine the optimal dose of topotecan when used in combination with high-dose melphalan and cyclophosphamide (TMC), and to assess the toxicity and efficacy of the regimen in patients with advanced ovarian cancer. METHODS Fifty-three patients with persistent or recurrent ovarian cancer were treated. Disease status at study entry included: platinum-sensitive recurrent disease (15 patients), platinum-resistant or refractory recurrent disease (15 patients), positive second-look surgery (16 patients), failure to achieve a primary clinical complete response (CR) (7 patients). Following stem cell mobilization and collection, patients were given cyclophosphamide 1 g/m(2)/day on Days -6, -5, -4; melphalan 70 mg/m(2)/day on Days -3, -2; and topotecan at escalating doses from 1.25 to 4.0 mg/m(2)/day on Days -6 to -2. Peripheral blood stem cells were infused on Day 0. RESULTS The optimal topotecan dose selected for future trials was 4.0 mg/m(2)/day x 5 days. The regimen had acceptable toxicity with no regimen-related death. Toxicity (Bearman toxicity criteria) was limited mostly to grade 1-2 mucositis and diarrhea. The overall response rate of patients with measurable or evaluable disease was 93%. Median survival has not yet been reached, but with a median follow up of 18 months (range: 11-37) 77% of patients are alive. CONCLUSION With a topotecan dose of 4.0 mg/m(2)/day x 5 days, the TMC regimen has acceptable toxicity and produces high response rates. In the setting of ovarian cancer, high-dose chemotherapy should be administered only as part of well-designed clinical trials. TMC should be considered a potential regimen for future randomized trials in patients with advanced ovarian cancer.
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Affiliation(s)
- M L Donato
- Department of Blood and Marrow Transplantation, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Feasel AM, Donato ML, Duvic M. Complete remission of scleromyxedema following autologous stem cell transplantation. Arch Dermatol 2001; 137:1071-2. [PMID: 11493100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A M Feasel
- Division of Internal Medical Specialties, Department of Dermatology-Box 434, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77005, USA
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Donato ML, Champlin RE, Wharton JT, Bodurka-Bevers D, Gershenson D. Intensive-dose ifosfamide and etoposide with filgrastim for cytoreduction before peripheral blood stem cell collection in patients with advanced ovarian cancer. EUR J GYNAECOL ONCOL 2001; 21:241-4. [PMID: 10949384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To evaluate the antitumor activity and toxic effects of intensive-dose ifosfamide plus etoposide with filgrastim given as stem cell mobilization therapy before high-dose chemotherapy for recurrent or persistent ovarian cancer. METHODS We studied 32 patients with epithelial ovarian cancer who had a positive second-look laparatomy or recurrent disease. Ifosfamide was given at 10 g/m2 (total dose) by continuous infusion over 72 h; etoposide was given at 150 mg/m2 in 2-h infusions every 12 h during the same 72-h period; and filgrastim was given at 10 microg/kg/day subcutaneous injection from day 5 through completion of stem cell harvest. RESULTS Nine (64%) of the 14 patients assessed responded to the treatment. The target stem cell dose was achieved with a median of 1 apheresis (range 1-5 aphereses). Nonhematologic toxicity was limited to grade 2 nephrotoxicity in one patient and grade 2 hepatic toxicity in three patients. CONCLUSIONS In this patient group, intensive-dose ifosfamide plus etoposide with filgrastim was well tolerated and produced antitumor activity.
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Affiliation(s)
- M L Donato
- The University of Texas M.D. Anderson Cancer Center Houston, USA
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Donato ML, Gershenson D, Ippoliti C, Wharton JT, Bast RC, Aleman A, Anderlini P, Gajewski JG, Giralt S, Molldrem J, Ueno N, Lauppe J, Korbling M, Boyer J, Bodurka-Bevers D, Bevers M, Burke T, Freedman R, Levenback C, Wolf J, Champlin RE. High-dose ifosfamide and etoposide with filgrastim for stem cell mobilization in patients with advanced ovarian cancer. Bone Marrow Transplant 2000; 25:1137-40. [PMID: 10849525 DOI: 10.1038/sj.bmt.1702421] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation has shown promise as treatment for recurrent or persistent epithelial ovarian cancer. We evaluated the stem cell mobilization regimen of high-dose ifosfamide plus etoposide in 32 patients with epithelial ovarian cancer, who had a positive second-look laparatomy or recurrent disease. Ifosfamide was given at 10 g/m2 by continuous i.v. from days 1 to 3. Etoposide was given at 150 mg/m2 every 12 h for six doses on days 1-3. Filgrastim was given at 10 microg/kg/d s.c. from day 5 until the completion of peripheral blood stem cell harvest. Fourteen of 32 patients had measurable or evaluable disease before mobilization therapy and were assessed for response. In nine (64%) of the 14 patients, treatment response was demonstrated, and these patients received a second cycle of mobilization therapy. The target CD34+ cell dose (>8 x 106 cells/kg) was achieved with a median of one apheresis (range 1-5). A median of 25.1 (range 8.0-122.5) x 106 CD34+ cells/kg body weight was collected. Non-hematologic toxicity was limited to grade 2 renal dysfunction in one patient and grade 2 hepatic dysfunction in three patients. In this patient group, high-dose ifosfamide plus etoposide with filgrastim support was well tolerated, lead to successful stem cell harvest and had antitumor activity.
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Affiliation(s)
- M L Donato
- Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Donato ML, Champlin RE, Van Besien KW, Korbling M, Cabanillas F, Anderlini P, Gajewski JG, Lauppe J, Durett A, Andersson B, Giralt S, Khouri I, Hagemeister F, Romaguera JE, Sarris A, McLaughlin P, Younes A, Ippoliti C, Blamble DA, Hester J, Gee A, Rodriguez MA. Intensive dose ifosfamide and etoposide with G-CSF for stem cell mobilization in patients with non-Hodgkin's lymphoma. Leuk Lymphoma 1999; 35:317-24. [PMID: 10706456 DOI: 10.3109/10428199909145736] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We studied 36 patients with non-Hodgkin's lymphoma to evaluate the stem cell yield following recovery from intensive dose ifosfamide and etoposide given as mobilization chemotherapy. We also assessed the toxicity of the regimen and engraftment kinetics. All patients had intermediate grade lymphoma and had either failed to achieve a complete remission to induction chemotherapy or had relapsed. Patients received ifosfamide 10 g/m2 IV total dose given over 72 hours, etoposide 150 mg/m2 IV every 12 hours for 6 doses and G-CSF 10 microg/kg/d. Thirty-four patients went on to receive high-dose chemotherapy with BEAM or with CVP and BEAM. A median of 2 (1-10) apheresis was required to reach the target CD34+ count of >4 x 10(6)/kg. A median of 13.1 CD34+ cells/kg (4.1-148) was obtained. Toxicity was limited to mucositis in 3 patients, transient confusion and transient rise in liver function tests in 3 and 2 patients respectively. The median time to engraftment was 10 days (8-17) for all the patients undergoing high-dose chemotherapy. The regimen of intensive dose ifosfamide and etoposide along with G-CSF is well tolerated and in this group of patients has lead to successful stem cell harvests and sustained engraftment.
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Affiliation(s)
- M L Donato
- The University of Texas MD Anderson Cancer Center, Houston 77030, USA
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