STANDARD-DOSE RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR(RHG-CSF) ALLOWS SAFE AND REPEATED ADMINISTRATION OF HIGH-DOSE CYCLOPHOSPHAMIDE, ETOPOSIDE, AND CISPLATIN (CEP)

High-dose chemotherapy often requires hematopoietic progenitor cell re infusion, but drugs with extramedullary dose-limiting toxicity may be administered in the high-dose range by simple growth factor support. I n this study, we evaluated the feasibility and toxicity of a three-dru g high-dose regimen supported by recombinant human granulocyte colony- stimulating factor (rhG-CSF). Ten patients with histologically proven malignancy were enrolled. Eight had breast cancer, one non-Hodgkin's l ymphoma, and one a mediastinal tumor of unknown origin. The regimen in cluded cyclophosphamide (C) 5 g/m(2), etoposide (E) 1.5 g/m(2), and ci splatin (P) 150 mg/m(2) (CEP), administered in a 3-day schedule follow ed by rhc-CSF, 300 mu g once a day, beginning from day +5 (36 h after the end of chemotherapy). The cycle was repeated as clinically needed up to three times. After the first course, hematologic recovery was ra pid and complete without documented infections, and no relevant extram yeloid toxicities were observed. Eight of 10 patients received a secon d course with comparably low toxicity, and three of them received a th ird course. We concluded that CEP therapy can be administered safely a nd even repeatedly, by simple growth factor support, in good performan ce status cancer patients.