Failure of granulocyte-macrophage colony-stimulating factor to reduce febrile neutropenia in children with recurrent solid tumors treated with ifosfamide, carboplatin, and etoposide chemotherapy.
Failure of granulocyte-macrophage colony-stimulating factor to reduce febrile neutropenia in children with recurrent solid tumors treated with ifosfamide, carboplatin, and etoposide chemotherapy.
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粒细胞-巨噬细胞集落刺激因子未能减少接受异环磷酰胺、卡铂和依托泊苷化疗治疗的复发性实体瘤儿童的发热性中性粒细胞减少症。
DOI：
10.1002/mpo.2950230403
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Meyer,WH
中科院分区：
文献类型：
--
作者：
Marina,NM;Shema,SJ;Bowman,LC;Rodman,J;Douglass,EC;Furman,WL;Pappo,A;Santana,VM;Hudson,M;Meyer,WH
异环磷酰胺、卡铂和依托泊苷(ICE)联合化疗对多种实体瘤具有良好的抗肿瘤活性，但会产生明显的骨髓毒性，造血生长因子可能会改善这种毒性。12例复发性实体瘤患者接受ICE化疗。卡铂剂量为8 mg/m L×m in(根据患者的肾小球滤过率进行调整)，第2~4天给予异环磷酰胺2g/m2和依托泊苷100 mg/m~2。粒细胞-巨噬细胞集落刺激因子1,000μ/m~2/d，每个疗程后24小时开始给药，连续给药17天，直到中性粒细胞绝对值达到10×109/L。患者接受了3个疗程的中位数(范围1-8)。20例患者均出现4级中性粒细胞减少和3级或4级血小板减少。接受GM-CSF治疗的患者中性粒细胞减少的中位持续时间显著缩短(16.75vs.10天，P=0.005)。然而，两组在因中性粒细胞减少症住院相关的病程比例、住院时间或血小板减少症的中位数方面没有不同。ICE加GM-CSF治疗的12例患者有2例完全缓解，4例部分缓解，3例客观缓解；8例单纯ICE治疗的患者有2例部分缓解和3例客观缓解。GM-CSF不能减少ICE化疗引起的中性粒细胞减少症或血小板减少症的持续时间。与这种有希望的组合相结合的其他造血生长因子的研究是值得的。©1994 Wiley-Liss，Inc.
Ifosfamide, carboplatin, and etoposide (ICE) chemotherapy has promising activity against various solid tumors but produces significant myelotoxicity that might be ameliorated by hematopoietic growth factors. Twelve patients with relapsed solid tumors were treated with ICE chemotherapy. Carboplatin was given on day 1 at a targeted area under the concentration‐time curve (AUC) of 8 mg/mL × min (adjusted for each patient's glomerular filtration rate), followed by ifosfamide 2 g/m2and etoposide 100 mg/m2on days 2 through 4. Granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), 1,000 μg/m2/day, was started 24 hours after each course and given for 17 days or until the absolute neutrophil count (ANC) reached 10 × 109/L. Myelotoxicity and responses in these patients were compared to those of eight patients who received the same therapy without GM‐CSF. Patients received a median of three courses (range, 1–8). All 20 patients developed grade 4 neutropenia and grade 3 or 4 thrombocytopenia. The median duration of neutropenia was significantly shorter in patients who received GM‐CSF (16.75 vs. 10 days,P= 0.005). However, the two groups did not differ in the proportion of courses associated with hospitalization for febrile neutropenia, the duration of hospitalization, or the median duration of thrombocytopenia. There were two complete, four partial, and three objective responses in the 12 patients treated with ICE plus GM‐CSF, and two partial and three objective responses in the 8 patients treated with ICE only. GM‐CSF did not reduce the occurrence of febrile neutropenia or the duration of thrombocytopenia associated with ICE chemotherapy. Studies of other hematopoietic growth factors in conjunction with this promising combination are merited. © 1994 Wiley‐Liss, Inc.