TY - JOUR
T1 - Erythropoietin addition to granulocyte colony-stimulating factor abrogates life-threatening neutropenia and increases peripheral-blood progenitor-cell mobilization after epirubicin, paclitaxel, and cisplatin combination chemotherapy
T2 - Results of a randomized comparison
AU - Pierelli, Luca
AU - Perillo, Alessandro
AU - Greggi, Stefano
AU - Salerno, Giovanna
AU - Benedetti Panici, Pierluigi
AU - Menichella, Giacomo
AU - Fattorossi, Andrea
AU - Leone, Giuseppe
AU - Mancuso, Salvatore
AU - Scambia, Giovanni
PY - 1999/4
Y1 - 1999/4
N2 - Purpose and Methods: The ability of granulocyte colony-stimulating factor (G-CSF) plus erythropoietin (EPO) treatment was compared in a randomized fashion with that of G-CSF treatment alone in promoting hematologic recovery and peripheral-blood progenitor-cell (PBPC) mobilization in previously untreated patients with advanced ovarian cancer who underwent their first course of epirubicin, paclitaxel, and cisplatin (ETP) chemotherapy during a phase II study of intensive outpatient ETP chemotherapy followed high-dose carboplatin, etoposide, and melphalan (CEM) late intensification with PBPC support. Results: Comparative analysis of hematologic recovery of 50 randomized patients, after ETP chemotherapy, showed that life-threatening neutropenia occurred in 88% of the patients treated with G-CSF alone, whereas it occurred in only 4% of patients treated with G-CSF + EPO. Significantly different WBC and polymorphonuclear leukocyte (PMN) counts were observed in the two distinct arms on the day of WBC nadir (P <.0001 and P <.0001, respectively). Moreover, the addition of EPO to G- CSF increased PBPC mobilization and collection os compared with that in G- CSF-treoted patients (P = .0009 and P = .0026, respectively), who required o significantly higher number of leukaphereses than G-CSF + EPO-treated patients (P = .0076) to obtain the planned minimum dose of PBPCs. Qualitative analysis cloning assay of PBPCs collected in both arms revealed that G-CSF- and G-CSF + EPO-mobilized PBPCs have comparable in vitro functional properties. Conclusion: This randomized comparison revealed that EPO significantly increases most of the hematologic effect produced G-CSF administration after chemotherapy. This biologic property of EPO translated in viva into a global improvement of patients' hematologic status.
AB - Purpose and Methods: The ability of granulocyte colony-stimulating factor (G-CSF) plus erythropoietin (EPO) treatment was compared in a randomized fashion with that of G-CSF treatment alone in promoting hematologic recovery and peripheral-blood progenitor-cell (PBPC) mobilization in previously untreated patients with advanced ovarian cancer who underwent their first course of epirubicin, paclitaxel, and cisplatin (ETP) chemotherapy during a phase II study of intensive outpatient ETP chemotherapy followed high-dose carboplatin, etoposide, and melphalan (CEM) late intensification with PBPC support. Results: Comparative analysis of hematologic recovery of 50 randomized patients, after ETP chemotherapy, showed that life-threatening neutropenia occurred in 88% of the patients treated with G-CSF alone, whereas it occurred in only 4% of patients treated with G-CSF + EPO. Significantly different WBC and polymorphonuclear leukocyte (PMN) counts were observed in the two distinct arms on the day of WBC nadir (P <.0001 and P <.0001, respectively). Moreover, the addition of EPO to G- CSF increased PBPC mobilization and collection os compared with that in G- CSF-treoted patients (P = .0009 and P = .0026, respectively), who required o significantly higher number of leukaphereses than G-CSF + EPO-treated patients (P = .0076) to obtain the planned minimum dose of PBPCs. Qualitative analysis cloning assay of PBPCs collected in both arms revealed that G-CSF- and G-CSF + EPO-mobilized PBPCs have comparable in vitro functional properties. Conclusion: This randomized comparison revealed that EPO significantly increases most of the hematologic effect produced G-CSF administration after chemotherapy. This biologic property of EPO translated in viva into a global improvement of patients' hematologic status.
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M3 - Article
C2 - 10561191
AN - SCOPUS:0032930689
VL - 17
SP - 1288
EP - 1295
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 4
ER -