A STUDY OF OVARIAN-CANCER PATIENTS TREATED WITH DOSE-INTENSIVE CHEMOTHERAPY SUPPORTED WITH PERIPHERAL-BLOOD PROGENITOR CELLS MOBILIZED BY FILGRASTIM AND CYCLOPHOSPHAMIDE

We have shown that large numbers of haemopoietic progenitor cells are mobilised into the blood after filgrastim [granulocyte colony-stimulat ing factor (G-CSF)] alone and filgrastim following cyclophosphamide ch emotherapy in previously untreated patients with ovarian cancer. These cells may be used to provide safe and effective haemopoietic rescue f ollowing dose-intensive chemotherapy. Using filgrastim alone (10 mu g kg(-1)), the apheresis harvest contained a median CFU-GM count of 45 x 10(4) kg(-1) and 2 x 10(6) kg(-1) CD34(+) cells. Treatment with filgr astim (5 mu g kg(-1)) following cyclophosphamide (3 g m(-2)) resulted in a harvest containing 66 x 10(4) kg(-1) CFU-GM and 2.4 x 10(6) kg(-1 ) CD34(+) cells. There was no statistically significant difference bet ween these two mobilising regimens. We have also demonstrated that dos e-intensive carboplatin and cyclophosphamide chemotherapy can be deliv ered safely to patients with ovarian cancer when supported by peripher al blood progenitor cells and filgrastim. Carboplatin (AUC 7.5) and cy clophosphamide (900 mg m(-2)) given at 3 weekly intervals with progeni tor cell and growth factor support was well tolerated in terms of haem atological and systemic side-effects. Double the dose intensity of che motherapy was delivered compared with our standard dose regimen when t he treatment was given at 3 weekly intervals. Median dose intensity co uld be further escalated to 2.33 compared with our standard regimen by decreasing the interval between treatment cycles to 2 weeks. However, at this dose intensity less than a third of patients received their p lanned treatment on time. All the delays were due to thrombocytopenia.