PERIPHERAL-BLOOD STEM-CELL COLLECTIONS AFTER PACLITAXEL, CYCLOPHOSPHAMIDE, AND RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR IN PATIENTS WITH BREAST AND OVARIAN-CANCER

Purpose: Here we evaluate Taxol (paclitaxel; Bristol-Myers Squibb, pri nceton, NJ) and cyclophosphamide (CY) with recombinant human granulocy te colony-stimulating factor (rhG-CSF) for mobilization of peripheral- blood stem cells (PBSCs) for autologous stem-cell transplantation in p atients with breast and ovarian cancer. Patients and Methods: PBSCs we re collected from 17 patients with breast (n = 11), ovarian (n = 5), a nd gastric (n = 1) cancer after administration of Taxol (170 mg/m(2) x 1) and CY (4 g/m(2) x 1) followed by rhG-CSF (10 mu g/kg/d). PBSC col lections after Taxol and CY were compared with PBSC collections from n ine patients with stage IV breast (n = 8) or stage III ovarian (n = 1) cancer who had received CY (4 g/m(2) x 1) followed by rhG-CSF (16 mu g/kg/d) for mobilization. Results: Mean WBC and platelet counts on the first day of apheresis were 6.3 x 10(9)/L(range, 1.9 to 22.1) and 35 x 10(9)/L(range, 19 to 77), respectively. The median numbers of CD34() cells, peripheral-blood mononuclear cells (PBTNC), and peripheral-bl ood total nucleated cells (PBTNC) collected were 13.02 x 10(6)/kg (ran ge, 5.4 to 57.8; mean, 16.02), 6.86 x 10(8)/kg (range, 1.9 to 51.2), a nd 17.41 x 10(8)/kg (range, 2.4 to 106.6), respectively, In the compar ison group, the median yield of CD34(+) cells was 6.39 x 10(6)/kg (ran ge, 0.2 to 28; mean, 10.01; P = .01). The mean daily yield of CD34(+) cells/kg/collection was 3.5 (range, 0.8 to 28.9) after Taxol and CY, a s compared with 1.3 (range, 0.1 to 7.0) for patients who received CY a lone (P = .01). All patients who received CY and Taxol reached a targe t level of 5 x 10(6) CD34(+) cells/kg, as compared with five of nine p atients (55.5%) who received CY alone (P = .03). Conclusion: These dat a suggest that Taxol and CY followed by rhG-CSF mobilizes PBSCs in pat ients with advanced breast and ovarian cancer more effectively than th is regimen without Taxol.