Intermediate dose etoposide plus G-CSF 16 g kg is more effective than cyclophosphamide 4 g m2 plus G-CSF 10 g kg in PBSC mobilization of lymphoma patients

• Published in: Leukemia & lymphoma 2007, Vol.48 (10), p.1950-1960
• Main Authors: Milone, Giuseppe, Leotta, Salvatore, Battiato, Katia, Murgano, Pamela, Mercurio, Salvatore, Strano, Aurora, Poidomani, Massimo, Coppoletta, Stefania, Mauro, Elisa, Avola, Giuseppe, Pinto, Valeria, Camuglia, Maria Grazia, Giustolisi, Rosario
• Format: Article
• Language: English
• Subjects: Etoposide; lymphoma; PBSC mobilization
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428190701573240

We designed intermediate dose etoposide + G-CSF 16 µg kg as a Peripheral Blood Stem Cell (PBSC) mobilization schedule suitable for outpatient administration. Forty-one Lymphoma patients received intermediate dose etoposide (200 mg m2 i.v. day +1, +2, +3) +G-CSF 16 µg kg day. Results of PBSC mobilization in these patients were compared with those of a group of 37 lymphoma patients mobilized using cyclophosphamide (CTX) at dosage of 4 g m2 + G-CSF 10 µg kg die. Mean peak of CD34+ cells achieved in P.B. and total CD34+ cells harvested were higher in patients mobilized with intermediate dose etoposide (p = 0.003 and p = 0.004, respectively). After transplantation recovery of polymorphonucleate neutrophils (PMN) > 0.5 × 109 L did not differ significantly between groups: 11.7 days in intermediate dose etoposide group and 11.5 days in CTX group (p = 0.7). Intermediate dose etoposide + G-CSF 16 µg kg resulted in a maximum length of neutropenia (PMN < 0.5 × 109 L) of 2 days and neutropenic fever was registered during only 3 41 courses (7.3%). Intermediate dose etoposide + G-CSF 16 µg kg is a highly effective mobilizing therapy, further, it has the advantage of low hematologic toxicity and can be easily administered as outpatient treatment.