Mobilization, collection, and characterization of peripheral blood hemopoietic progenitors after chemotherapy with epirubicin, paclitaxel, and granulocyte-colony stimulating factor administered to patients with metastatic breast carcinoma

Carmelo Bengala, Ilaria Pazzagli, Carmelo Tibaldi, Claudio Favre, Renato Vanacore, Francesco Greco, Alessandro Mazzoni, Maria Cristina Menconi, Pierantonio Macchia, Pier Franco Conte

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. As single agents, both paclitaxel and epirubicin in combination with cytokines can mobilize peripheral blood progenitor cells (PBPCs). The authors have demonstrated previously that the combination of epirubicin and paclitaxel is very active against metastatic breast carcinoma and tolerated by patients. METHODS. Twenty-one patients with metastatic breast carcinoma received epirubicin 90 mg/m2 in combination with paclitaxel 200 mg/m2 given as a 3-hour infusion, and granulocyte-colony stimulating factor (G-CSF) starting 24 hours after chemotherapy to mobilize PBPCs. An immunophenotypic analysis for CD3, CD4, CD8, CD19, CD33, CD34, and CD38 antigen expression was performed on apheresis products. Eighteen patients underwent high dose chemotherapy and were engrafted with PBPCs primed with paclitaxel, epirubicin, and G-CSF. RESULTS. The median number of circulating CD34+ cells at peak was 70/μL; in the patients less heavily pretreated, it was 106.7/μL. The mean number of CD34+, CD34+/CD33-, and CD34+/CD38- cells/kg collected per apheresis was 6.3 x 106, 2.0 x 108, and 0.18 x 106, respectively. The mean number of CD34+ cells/kg per apheresis was 7.8 x 106 when the preleukapheresis CD34+ cell count was more than 50/μL and 0.9 x 106 when the CD34+ cell count was less than 50/μL. The mean number of CD3+, CD4+, and CD8+ cells/kg collected per apheresis was 90 x 106, 50 x 106, and 30 x 106, respectively. CONCLUSIONS. Epirubicin plus paclitaxel in combination with G-CSF mobilizes PBPCs, including more primitive progenitors capable of supporting myeloablative treatment. Moreover, the mononuclear cells collected in this study contained high levels of cytotoxic effector cells suitable for ex vivo manipulation to augment the antitumor effect.

Original languageEnglish
Pages (from-to)867-873
Number of pages7
JournalCancer
Volume82
Issue number5
DOIs
Publication statusPublished - Mar 1 1998

Keywords

  • Epirubicin
  • High dose chemotherapy
  • Paclitaxel
  • Peripheral blood progenitors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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