LOW-DOSE CYCLOPHOSPHAMIDE IN COMBINATION WITH CISPLATIN OR EPIRUBICINPLUS RHG-CSF ALLOWS ADEQUATE COLLECTION OF PBSC FOR AUTOTRANSPLANTATION DURING ADJUVANT THERAPY FOR HIGH-RISK CANCER

Six patients with advanced ovarian carcinoma (OvCa), and six patients with stage II or III resectable breast cancer (BrCa) were treated with low-dose CY (LD-CY, 1500 mg/m(2)) and cisplatin (CDDP) 100 mg/m(2) (O vCa) or epirubicin (EPR) 120 mg/m(2) (BrCa) plus recombinant human G-C SF (rhG-CSF). Twelve days after chemotherapy, all patients underwent P BSC collection on an outpatient basis, Following the completion of the induction programme, all patients underwent high-dose chemotherapy (H DC) with carboplatin 1200 mg/m(2), etoposide 900 mg/m(2) and melphalan 100 mg/m(2) with the reinfusion of PBSC. LD-CY plus rhG-CSF in combin ation with CDDP or EPR mobilised a very large number of PBSC. After a median of 13 days from chemotherapy, the concentration of PBSC in the peripheral blood was 40-fold higher than the same patient's baseline v alue. Each collection yielded a median of 10.8 x 10(4)/kg colony-formi ng unit granulocyte-macrophage. Severe myelosuppression occurred in al l patients following HDC, but the infusion of PBSC produced a rapid an d sustained haemopoietic recovery. After a median of 11 days from rein fusion, haemopoietic engraftment was complete and 80% of the patients had platelets > 100 x 10(9)/l and PMN > 1 X 10(9)/l within 14 days aft er reinfusion. We can conclude that the present therapeutic approach i s an excellent option for mobilisation, collection and transplantation of PBSC during intensive dose adjuvant polychemotherapy of high-risk cancer.