MOBILIZATION OF PERIPHERAL-BLOOD PROGENITOR CELLS WITH HIGH-DOSE ETOPOSIDE AND GRANULOCYTE-COLONY-STIMULATING FACTOR IN PATIENTS WITH BREAST-CANCER, NON-HODGKINS-LYMPHOMA, AND HODGKINS-DISEASE

Purpose: We analyzed the safety and effectiveness of high-dose etoposi de (2 g/m(2)) followed by granulocyte colony-stimulating factor (G-CSF ) as a peripheral-blood progenitor cell (PBPC) mobilization regimen an d assessed extent of tumor reduction in patients with breast cancer, n on-Hodgkin's lymphoma (NHL), and Hodgkin's disease (HD). Patients and Methods: On hundred sixty-nine consecutive patients who eventually und erwent PBPC transplantation received treatment with high-dose etoposid e (2 g/m(2)) followed by daily G-CSF (5 mu g/kg). Results: This mobili zation method was effective in nearly all patients. No patients died o f mobilization-related complications. A 50% reduction in tumor size wa s seen in 19% of assessable patients with breast cancer, 44% of those with NHL, and 38% of those with HD. Hematopoietic recovery (HR) follow ing transplantation occurred in all patients. Patients with greater th an or equal to 4 x 10(6) CD34(+) cells/kg engrafted with neutrophils a t a median of 9 days after transplant and patients with at least 1.2 x 10(6) CD34(+)/CD33(-) cells/kg achieved platelet recovery at a median of 15 days. Conclusion: Etoposide plus G-CSF is an effective and sale method for mobilization of PBPCs. Etoposide is an effective agent in tumor reduction in NHL and HD and is less effective in breast cancer. The substantially lower incidence of prior exposure to this agent comp ared with cyclophosphamide favors its use. (C) 1997 by American Societ y of Clinical Oncology.