EPIRUBICIN PLUS G-CSF AS PERIPHERAL-BLOOD PROGENITOR CELLS (PBPC) MOBILIZING AGENTS IN BREAST-CANCER PATIENTS

Background: In an attempt to mobilise peripheral blood progenitor cell s (PBPC) from patients with breast cancer, Epirubicin supported with G -CSF was tested. Another aim of the study was also to optimize the pro cedure so that the number of leukapheresis procedures could be reduced . These cells were subsequently reinfused as hematologic res cue after high-dose chemotherapy programs. Patients and methods: Twenty-nine pa tients received Epirubicin 150 mg/sqm + G-CSF at the dose of 5 mu g/kg /bw s.c. daily, starting 24 hours after chemotherapy. Twelve had metas tatic, eight inflammatory or locally advanced disease, and nine were t reated in an adjuvant setting. Results:. The median numbers of CD34+ c ells and CFU-GM collected were 12.9 x 10(6)/kg/bw and 111.7 x 10(4)/kg /bw, respectively. The mean number of leukapheresis procedures per pat ient was 1.8 +/- 0.3 (range 1-3), and the mean day of the first proced ure was the tenth +/-1 (range 8-13) after Epirubicin. The minimum requ ired target for one high-dose procedure was collected in a single leuk apheresis in 13 patients. Moreover, in 9 cases one procedure was adequ ate for two high-dose courses (i.e. greater than or equal to 10 x 10(6 )/kg/bw CD34+ cells). Response to Epirubicin was evaluable in 14/20 ca ses, with a response rate of 50%. Conclusions: Epirubicin delivered at 150 mg/sqm is a very effective mobilising agent for breast cancer pat ients; to ameliorate the response rate other active drug(s) should be added.