Collection of peripheral blood stem cells following administration of paclitaxel, cyclophosphamide, and filgrastim in patients with breast and ovarian cancer

Charles H. Weaver, Lee Schwartzberg, Robert Birch, F. Anthony Greco, John Hainsworth, Robert Drapkin, Luis Campos, Richard Grapski, John Schwerkoske, Julio Lautersztain, Bonni Hazelton, Frederick Schnell, William Babcock, C. Dean Buckner

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Abstract

Purpose. To determine the toxicities and efficacy of paclitaxel, cyclophosphamide (Cy), and recombinant human granulocyte-colony stimulating factor (filgrastim) administered for mobilization and collection of peripheral blood stem cells (PBSC) in patients with breast and ovarian cancer. Methods. One hundred and forty-one patients with breast (n=115) or ovarian cancer (n=26) received paclitaxel 170 mg/m2 and Cy 2 gm/m2 (n=42) or paclitaxel 200 mg/m2, Cy 3 gm/m2 (n=99), and filgrastim (6 μg/kg/day) followed by collection of PBSC by apheresis. Results. The 2 dose levels of paclitaxel and Cy tested were well tolerated. The median yield of CD34+ cells from all patients was 6.53 × 106/kg (range, 0.11-51.76) collected with a median of 2 aphereses (range, 1-8). The target dose of 2.5 × 106 CD34+ cells/kg was achieved in 85% of patients. The mean daily collection of CD34+ cells was 5.46 × 106/kg for patients receiving 200 mg/m2 of paclitaxel and 3 gm/m2 of Cy as compared to 2.77 for patients receiving the lower doses (p = 0.0005). Increasing the dose of paclitaxel and Cy did not significantly increase the fraction of patients achieving a target dose of 2.5 × 106 CD34+ cells/kg (87% vs 81%, p = 0.367) but did increase the fraction achieving a target of 5.0 × 106 CD34+ cells/kg (73% vs 45%, p = 0.002). The mean daily collection of CD34+ cells for patients who had received only 1 prior chemotherapy regimen was 6.59 × 106/kg as compared to 3.47 for patients who had received more than 1 prior chemotherapy regimen (p < 0.0001). Prior radiation therapy (p = 0.003) and patient performance status (p = 0.047) were adverse risk factors for achieving a target dose of ≥2.5 × 106 CD34+ cells/kg. Conclusions. The combination of paclitaxel, Cy, and filgrastim can be administered with acceptable toxicity, allowing collection of adequate quantities of PBSC from the majority of patients with breast and ovarian cancer. Increasing the doses of paclitaxel and Cy increased the number of CD34+ cells collected and decreased the number of apheresis procedures necessary to collect target cell doses. However, increasing drug doses did not increase the fraction of patients yielding the minimum CD34+ target dose of 2.5 × 106/kg. Collection of PBSC early in the disease course is the best strategy to assure optimal CD34+ cell doses in all patients.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume3
Issue number2
StatePublished - Jun 1 1997

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Paclitaxel
Ovarian Neoplasms
Cyclophosphamide
Breast Neoplasms
Blood Component Removal
Filgrastim
Peripheral Blood Stem Cells
Drug Therapy
Granulocyte Colony-Stimulating Factor
Breast
Radiotherapy
Cell Count

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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Collection of peripheral blood stem cells following administration of paclitaxel, cyclophosphamide, and filgrastim in patients with breast and ovarian cancer. / Weaver, Charles H.; Schwartzberg, Lee; Birch, Robert; Greco, F. Anthony; Hainsworth, John; Drapkin, Robert; Campos, Luis; Grapski, Richard; Schwerkoske, John; Lautersztain, Julio; Hazelton, Bonni; Schnell, Frederick; Babcock, William; Buckner, C. Dean.

In: Biology of Blood and Marrow Transplantation, Vol. 3, No. 2, 01.06.1997, p. 83-90.

Research output: Contribution to journalArticle

Weaver, CH, Schwartzberg, L, Birch, R, Greco, FA, Hainsworth, J, Drapkin, R, Campos, L, Grapski, R, Schwerkoske, J, Lautersztain, J, Hazelton, B, Schnell, F, Babcock, W & Buckner, CD 1997, 'Collection of peripheral blood stem cells following administration of paclitaxel, cyclophosphamide, and filgrastim in patients with breast and ovarian cancer', Biology of Blood and Marrow Transplantation, vol. 3, no. 2, pp. 83-90.
Weaver, Charles H. ; Schwartzberg, Lee ; Birch, Robert ; Greco, F. Anthony ; Hainsworth, John ; Drapkin, Robert ; Campos, Luis ; Grapski, Richard ; Schwerkoske, John ; Lautersztain, Julio ; Hazelton, Bonni ; Schnell, Frederick ; Babcock, William ; Buckner, C. Dean. / Collection of peripheral blood stem cells following administration of paclitaxel, cyclophosphamide, and filgrastim in patients with breast and ovarian cancer. In: Biology of Blood and Marrow Transplantation. 1997 ; Vol. 3, No. 2. pp. 83-90.
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abstract = "Purpose. To determine the toxicities and efficacy of paclitaxel, cyclophosphamide (Cy), and recombinant human granulocyte-colony stimulating factor (filgrastim) administered for mobilization and collection of peripheral blood stem cells (PBSC) in patients with breast and ovarian cancer. Methods. One hundred and forty-one patients with breast (n=115) or ovarian cancer (n=26) received paclitaxel 170 mg/m2 and Cy 2 gm/m2 (n=42) or paclitaxel 200 mg/m2, Cy 3 gm/m2 (n=99), and filgrastim (6 μg/kg/day) followed by collection of PBSC by apheresis. Results. The 2 dose levels of paclitaxel and Cy tested were well tolerated. The median yield of CD34+ cells from all patients was 6.53 × 106/kg (range, 0.11-51.76) collected with a median of 2 aphereses (range, 1-8). The target dose of 2.5 × 106 CD34+ cells/kg was achieved in 85{\%} of patients. The mean daily collection of CD34+ cells was 5.46 × 106/kg for patients receiving 200 mg/m2 of paclitaxel and 3 gm/m2 of Cy as compared to 2.77 for patients receiving the lower doses (p = 0.0005). Increasing the dose of paclitaxel and Cy did not significantly increase the fraction of patients achieving a target dose of 2.5 × 106 CD34+ cells/kg (87{\%} vs 81{\%}, p = 0.367) but did increase the fraction achieving a target of 5.0 × 106 CD34+ cells/kg (73{\%} vs 45{\%}, p = 0.002). The mean daily collection of CD34+ cells for patients who had received only 1 prior chemotherapy regimen was 6.59 × 106/kg as compared to 3.47 for patients who had received more than 1 prior chemotherapy regimen (p < 0.0001). Prior radiation therapy (p = 0.003) and patient performance status (p = 0.047) were adverse risk factors for achieving a target dose of ≥2.5 × 106 CD34+ cells/kg. Conclusions. The combination of paclitaxel, Cy, and filgrastim can be administered with acceptable toxicity, allowing collection of adequate quantities of PBSC from the majority of patients with breast and ovarian cancer. Increasing the doses of paclitaxel and Cy increased the number of CD34+ cells collected and decreased the number of apheresis procedures necessary to collect target cell doses. However, increasing drug doses did not increase the fraction of patients yielding the minimum CD34+ target dose of 2.5 × 106/kg. Collection of PBSC early in the disease course is the best strategy to assure optimal CD34+ cell doses in all patients.",
author = "Weaver, {Charles H.} and Lee Schwartzberg and Robert Birch and Greco, {F. Anthony} and John Hainsworth and Robert Drapkin and Luis Campos and Richard Grapski and John Schwerkoske and Julio Lautersztain and Bonni Hazelton and Frederick Schnell and William Babcock and Buckner, {C. Dean}",
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T1 - Collection of peripheral blood stem cells following administration of paclitaxel, cyclophosphamide, and filgrastim in patients with breast and ovarian cancer

AU - Weaver, Charles H.

AU - Schwartzberg, Lee

AU - Birch, Robert

AU - Greco, F. Anthony

AU - Hainsworth, John

AU - Drapkin, Robert

AU - Campos, Luis

AU - Grapski, Richard

AU - Schwerkoske, John

AU - Lautersztain, Julio

AU - Hazelton, Bonni

AU - Schnell, Frederick

AU - Babcock, William

AU - Buckner, C. Dean

PY - 1997/6/1

Y1 - 1997/6/1

N2 - Purpose. To determine the toxicities and efficacy of paclitaxel, cyclophosphamide (Cy), and recombinant human granulocyte-colony stimulating factor (filgrastim) administered for mobilization and collection of peripheral blood stem cells (PBSC) in patients with breast and ovarian cancer. Methods. One hundred and forty-one patients with breast (n=115) or ovarian cancer (n=26) received paclitaxel 170 mg/m2 and Cy 2 gm/m2 (n=42) or paclitaxel 200 mg/m2, Cy 3 gm/m2 (n=99), and filgrastim (6 μg/kg/day) followed by collection of PBSC by apheresis. Results. The 2 dose levels of paclitaxel and Cy tested were well tolerated. The median yield of CD34+ cells from all patients was 6.53 × 106/kg (range, 0.11-51.76) collected with a median of 2 aphereses (range, 1-8). The target dose of 2.5 × 106 CD34+ cells/kg was achieved in 85% of patients. The mean daily collection of CD34+ cells was 5.46 × 106/kg for patients receiving 200 mg/m2 of paclitaxel and 3 gm/m2 of Cy as compared to 2.77 for patients receiving the lower doses (p = 0.0005). Increasing the dose of paclitaxel and Cy did not significantly increase the fraction of patients achieving a target dose of 2.5 × 106 CD34+ cells/kg (87% vs 81%, p = 0.367) but did increase the fraction achieving a target of 5.0 × 106 CD34+ cells/kg (73% vs 45%, p = 0.002). The mean daily collection of CD34+ cells for patients who had received only 1 prior chemotherapy regimen was 6.59 × 106/kg as compared to 3.47 for patients who had received more than 1 prior chemotherapy regimen (p < 0.0001). Prior radiation therapy (p = 0.003) and patient performance status (p = 0.047) were adverse risk factors for achieving a target dose of ≥2.5 × 106 CD34+ cells/kg. Conclusions. The combination of paclitaxel, Cy, and filgrastim can be administered with acceptable toxicity, allowing collection of adequate quantities of PBSC from the majority of patients with breast and ovarian cancer. Increasing the doses of paclitaxel and Cy increased the number of CD34+ cells collected and decreased the number of apheresis procedures necessary to collect target cell doses. However, increasing drug doses did not increase the fraction of patients yielding the minimum CD34+ target dose of 2.5 × 106/kg. Collection of PBSC early in the disease course is the best strategy to assure optimal CD34+ cell doses in all patients.

AB - Purpose. To determine the toxicities and efficacy of paclitaxel, cyclophosphamide (Cy), and recombinant human granulocyte-colony stimulating factor (filgrastim) administered for mobilization and collection of peripheral blood stem cells (PBSC) in patients with breast and ovarian cancer. Methods. One hundred and forty-one patients with breast (n=115) or ovarian cancer (n=26) received paclitaxel 170 mg/m2 and Cy 2 gm/m2 (n=42) or paclitaxel 200 mg/m2, Cy 3 gm/m2 (n=99), and filgrastim (6 μg/kg/day) followed by collection of PBSC by apheresis. Results. The 2 dose levels of paclitaxel and Cy tested were well tolerated. The median yield of CD34+ cells from all patients was 6.53 × 106/kg (range, 0.11-51.76) collected with a median of 2 aphereses (range, 1-8). The target dose of 2.5 × 106 CD34+ cells/kg was achieved in 85% of patients. The mean daily collection of CD34+ cells was 5.46 × 106/kg for patients receiving 200 mg/m2 of paclitaxel and 3 gm/m2 of Cy as compared to 2.77 for patients receiving the lower doses (p = 0.0005). Increasing the dose of paclitaxel and Cy did not significantly increase the fraction of patients achieving a target dose of 2.5 × 106 CD34+ cells/kg (87% vs 81%, p = 0.367) but did increase the fraction achieving a target of 5.0 × 106 CD34+ cells/kg (73% vs 45%, p = 0.002). The mean daily collection of CD34+ cells for patients who had received only 1 prior chemotherapy regimen was 6.59 × 106/kg as compared to 3.47 for patients who had received more than 1 prior chemotherapy regimen (p < 0.0001). Prior radiation therapy (p = 0.003) and patient performance status (p = 0.047) were adverse risk factors for achieving a target dose of ≥2.5 × 106 CD34+ cells/kg. Conclusions. The combination of paclitaxel, Cy, and filgrastim can be administered with acceptable toxicity, allowing collection of adequate quantities of PBSC from the majority of patients with breast and ovarian cancer. Increasing the doses of paclitaxel and Cy increased the number of CD34+ cells collected and decreased the number of apheresis procedures necessary to collect target cell doses. However, increasing drug doses did not increase the fraction of patients yielding the minimum CD34+ target dose of 2.5 × 106/kg. Collection of PBSC early in the disease course is the best strategy to assure optimal CD34+ cell doses in all patients.

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