Factors determining the actual received dose intensity in a program of multicyclic dose-intensive alternating chemotherapy with sequential stem cell support

Acta Haematol. 2001;105(3):137-42. doi: 10.1159/000046555.

Abstract

Dose intensity has been related to clinical outcome in several solid tumors. We studied the influence of clinical and cellular parameters on dose intensity received in a series of 53 patients with metastatic breast cancer or advanced ovarian cancer. They received courses of cisplatin 120 mg/m(2) plus etoposide 600 mg/m(2) alternating every 14 days with ifosfamide 8 g/m(2) plus paclitaxel 200--350 mg/m(2). Blood stem cell support was administered after every course except for the first one. Patients with excellent mobilization underwent immunomagnetic selection of CD34+ cells. We found a significant inverse correlation between the CD34+ cell dose infused and the delay for the administration of the next cycle. A CD34+ cell dose between 1.5 and 5 x 10(6)/kg per cycle was found to be feasible and was followed by a median delay of 1 day (not different from doses above 5 x 10(6)/kg). Three factors independently predicted the actually received dose intensity in a multiple regression model (R(2) = 0.4): previous autologous transplantation, eligibility for immunomagnetic selection (excellent response to mobilization) and median CD34+ cell dose received along the treatment.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antigens, CD34 / analysis
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / therapy*
  • Cell Count
  • Cisplatin / administration & dosage
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Etoposide / administration & dosage
  • Female
  • Hematopoietic Stem Cell Transplantation / methods
  • Hematopoietic Stem Cell Transplantation / standards*
  • Humans
  • Ifosfamide / administration & dosage
  • Immunomagnetic Separation
  • Middle Aged
  • Models, Biological
  • Ovarian Neoplasms / therapy*
  • Paclitaxel / administration & dosage
  • Stem Cells / immunology*
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Etoposide
  • Paclitaxel
  • Cisplatin
  • Ifosfamide