CIRCULATION OF PROGENITOR CELLS AFTER INTENSIVE CHEMOTHERAPY FOLLOWEDBY COMBINATION G-CSF AND EPO IN BREAST-CARCINOMA

Hematologic effects of granulocyte colony-stimulating factor (G-CSF) a nd erythropoietin (EPO) combination after priming intensive chemothera py in the treatment of female breast carcinoma are presented. In a pre vious group treated with G-CSF alone, 36% of patients became anemic an d had to be transfused for correction of their anemia. To the present study 11 consecutive patients with different stages of breast carcinom a were admitted. All were given priming intensive chemotherapy (epirub icin 150 mg/m(2) and cyclophosphamide 1300 mg/m(2)) followed by subcut aneous application of G-CSF at a dose of 5 mu g/kg/day and EPO 250 IU/ kg/day. In cases where leucocyte counts dropped below 1 x 10(9)/l and hemoglobin levels fell to 85 g/l administration of growth factors was started. The therapy was stopped when normal leucocyte count reached 4 x 10(9)/l for G-CSF and hemoglobin level rose to 115 g/l for EPO. Our results show significant difference between MNC/Tl (min.), CD34(+) ce lls/mu l (min.), CFU-GM/ml (min.), BFU-E/ml (min.) and MNC/mu l(max.), CD34(+) cells/mu l (max.), CFU-GM/ml(max.), BFU-E/ml(max.)p<0.01, wit h mean peak values of 16.9-fold for circulating MNC/mu l, 7.8-fold for CD34(+) cells/mu l, 23.4-fold for CFU-GM/ml and 28.7-fold increase fo r BFU-E/ml. Side effects were minimal, no infectious complications occ urred, body temperature did not rise over 38 degrees C and no correcti ons of anemia were needed. It is concluded that the administration of G-CSF plus EPO combination following intensive chemotherapy reduces he matologic toxicity and induces large amount of hemopoietic progenitors suitable for autologous transplantation in women with breast carcinom a.