High-Dose Etoposide with Granulocyte Colony-Stimulating Factor for Mobilization of Autologous Peripheral Blood Stem Cells in Patients with Hematologic Malignancies.

Abstract 4235

We hoped to explore the efficacy and safety of high-dose of etoposide with granulocyte colony-stimulating factor (G-CSF) for mobilization of peripheral blood stem cells. 43 patients (25 males and 18 females, 15-71years old) with hematologic malignancies, including 17 patients with multiple myeloma, 16 with non-Hodgkin's lymphoma, 1 with Hodgkin's lymphoma, 8 with acute non-lymphocytic leukemia, 1 with acute lymphocytic leukemia, received an etoposide dose of 1.6g/m². One of the patients had failed to be mobilized by cyclophosphamide and G-CSF before. The total dose of undiluted etoposide was given on day 1 as a continuous intravenous infusion via a central vein for 10 hours. G-CSF 5μg/kg was used on day 3 and given daily subcutaneously until leukopheresis was completed. The results showed that leukopheresis was started at days 10 (range 9-13 days) following etoposide therapy. the mean number of CD34 positive cells collected in all 43 patients was 9.71×10⁶/kg (range 0.5-53.26×10⁶/kg),by an average of 2.15 (range 1-5) leukophereses times. Mobilization procedure that produced yields of greater than 2 .0×10⁶/kg were achieved in 40 patients (including the one failed to be mobilized by cyclophosphamide and G-CSF). Toxicity showed oropharyngeal mucositis, faucitis, urethritis and upper respiratory tract infection in some patients. It is concluded that high-dose etoposide with G-CSF is an effective and safe mobilizing regimen for autologous peripheral blood stem cells in majority patients with hematologic malignancies.