Multicyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood.
Multicyclic, dose-intensive chemotherapy supported by sequential reinfusion of hematopoietic progenitors in whole blood.
复制标题
多周期、剂量密集化疗，由全血中的造血祖细胞顺序回输支持。
DOI：
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发表时间：
1995
影响因子：
45.3
通讯作者：
N. Testa
中科院分区：
文献类型：
--
作者：
R. Pettengell;P. Woll;N. Thatcher;T. Dexter;N. Testa
目的
为了支持多周期、剂量密集型化疗，我们评估了将每个周期收集的造血祖细胞重新输注到白细胞分离产品或全血中的效果。
患者和方法
25例小细胞肺癌（SCLC）患者接受了6个周期的异环磷酰胺、卡铂和依托泊苷（ICE）联合粒细胞集落刺激因子（G-CSF）300 μ g/d皮下（SC）治疗，治疗时间为第4 - 15天。在每个周期期间收集的造血祖细胞在下一个周期的第3天再输注。队列1（n = 6）每3周治疗一次，2周后进行白细胞去除术，并冷冻保存白细胞去除产物。如果WBC计数≥ 3 x 10（9）/L，血小板计数≥ 100 x 10（9）/L，则给予化疗。组群2（n = 7）每2周治疗一次，在下一个周期的第1天进行白细胞去除术，并将白细胞去除术产物储存在4 ℃。第3组（n = 12）每2周治疗一次，在下一个周期的第1天通过静脉采血抽取500至750 mL血液，并储存在4 ℃下。在队列2和3中，如果WBC计数≥ 3 × 10（9）/L且血小板计数≥ 30 × 10（9）/L，则给予化疗。分析血液和白细胞分离产物中的造血祖细胞。
结果
ICE化疗与G-CSF是有效的动员血液祖细胞（中位数，120倍）。长期培养没有显示出干细胞耗竭的证据。标准每4周一次ICE的细胞毒性剂量强度为100%。在前三个周期中，队列1为134%（中位数），队列2和3为200%（P < .0001）。毒性和支持性护理需求没有增加。
结论
ICE化疗的剂量强度可以通过再输注通过白细胞分离或静脉注射收集并储存在4 ℃下的造血祖细胞而加倍。
PURPOSE
To support multicyclic, dose-intensive chemotherapy, we assessed the effects of reinfusing hematopoietic progenitors collected at each cycle in leukapheresis product or whole blood.
PATIENTS AND METHODS
Twenty-five patients with small-cell lung cancer (SCLC) were treated with six cycles of ifosfamide, carboplatin, and etoposide (ICE) with granulocyte colony-stimulating factor (G-CSF) 300 micrograms/d subcutaneously (SC) on days 4 to 15. Hematopoietic progenitors collected during each cycle were reinfused on day 3 of the next cycle. Cohort 1 (n = 6) was treated every 3 weeks, with leukapheresis after 2 weeks and cryopreservation of the leukapheresis product. Chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 100 x 10(9)/L. Cohort 2 (n = 7) was treated every 2 weeks, with leukapheresis on day 1 of the next cycle and storage of the leukapheresis product at 4 degrees C. Cohort 3 (n = 12) was treated every 2 weeks, with 500 to 750 mL of blood drawn by venesection on day 1 of the next cycle and stored at 4 degrees C. In cohorts 2 and 3, chemotherapy was given if the WBC count was > or = 3 x 10(9)/L and platelet count > or = 30 x 10(9)/L. Blood and leukapheresis products were assayed for hematopoietic progenitors.
RESULTS
ICE chemotherapy with G-CSF was effective in mobilizing blood progenitors (median, 120-fold). Long-term cultures showed no evidence of stem-cell depletion. The cytotoxic dose-intensity of standard every-4-weeks ICE is 100%. In the first three cycles, it was 134% (median) in cohort 1 and 200% in cohorts 2 and 3 (P < .0001). Toxicity and supportive care requirements were not increased.
CONCLUSION
The dose-intensity of ICE chemotherapy can be doubled by reinfusing hematopoietic progenitors collected by leukapheresis or venesection and stored at 4 degrees C.
在重复高剂量环磷酰胺治疗期间，恢复性生长因子方案导致造血干细胞耗竭。
影响因子：
20.3
作者：
Hornung,RL;Longo,DL
通讯作者：
Longo,DL