Durability of hematopoiesis following autografting with peripheral blood hematopoietic progenitors

Siena, Salvatore; Bregni, Marco; Nicola, Massimo Di; Ravagnani, F.; Peccatori, Fedro Alessandro; Gandola, Lorenza; Lombardi, Fabrizio; Tarella, Corrado; Bonadonna, Gianni; Gianni, A. M.

doi:10.1093/oxfordjournals.annonc.a058733

Cited by 54 publications

(36 citation statements)

References 20 publications

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“…23 This might be related to legal issues, which were more stringent in the US, or possibly to a earlier confidence of European physicians on the durability of hematopoiesis following autografting of PB cells. 24 The clinical results of our retrospective analysis should be viewed considering that patients receiving HDC differ from the general population of women with BC. Thus, differences observed between patients receiving transplantation and those who received SDC in historical data bases may result from selection biases.…”

Section: Discussionmentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990–1999

Pedrazzoli

Ferrante

Kulekci³

et al. 2003

Bone Marrow Transplant

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Summary:The aim of this study was to identify trends in high-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (ASCT) and to assess survival in a large cohort of breast cancer (BC) patients receiving this therapy in Europe from 1990 to 1999. A total of 7471 patients who received HDC with ASCT between January 1, 1990 and December 31, 1999 were reported to the European Group for Blood and Marrow Transplantation Registry. Data required for demographics and survival analysis were available for 2679 patients with high-risk primary BC; 921 patients with inflammatory BC (IBC), and 2295 patients with metastatic disease. The main evaluation parameters were progression-free survival (PFS) and overall survival (OS). Between 1990 and 1998, autotransplants for BC increased 30-fold. Significant trends included use of blood-derived rather than marrow-derived stem cells, increment of reporting centers and decrease of mortality within 100 days from transplantation. The 5-year PFS and OS probabilities were 53 and 68% for high-risk disease and 42 and 53% for IBC, respectively. For metastatic disease 5-year PFS and OS probabilities in the whole cohort were 18 and 27%, respectively, while for women transplanted in complete remission the 5-year PFS was 29%. In conclusion, HDC with ASCT has been increasingly used until 1998 and the 100-day mortality rate has been constantly less than 2% from 1995 to date. The 5-year survival of high-risk BC is related to the number of axillary nodes involved at surgery. Outcome of patients with IBC is encouraging, suggesting the need for randomized trials. Patients with metastatic disease responding to pretransplant chemotherapy and harboring ER+ tumors have a better outcome.

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Section: Discussionmentioning

confidence: 99%

Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990–1999

Pedrazzoli

Ferrante

Kulekci³

et al. 2003

Bone Marrow Transplant

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“…21 A faster time to hematopoietic reconstitution determines a safer and less costly procedure compared to bone marrow transplantation. [3][4][5] In fact, in the last few years the number of autologous transplants with PBSC compared to bone marrow in breast cancer have increased significantly from 19% to Bone Marrow Transplantation 90% (P Ͻ 0.00001). In addition, the mortality rate has dropped from 22% to 5% (P Ͻ 0.00001), 22 and the initial doubts regarding durable long-term engraftment with PBSC are no longer a concern.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In addition, engraftment appears to be complete, and sustained. 3 This advantage has resulted in fewer complications derived from the profound aplasia that follows administration of intensive chemotherapy, making the procedure itself safer and less costly than bone marrow transplantation. [4][5][6] In fact, these advantages have facilitated the development of multiple studies in solid tumors in general, and in breast cancer in particular, designed to test the hypothesis that the resistance to conventional doses of chemotherapy is overcome by administering very high doses of chemotherapy.…”

mentioning

confidence: 99%

The role of granulocyte colony-stimulating factor (G-CSF) in the post-transplant period

Hornedo

Solá

Solano

et al. 2002

Bone Marrow Transplant

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“…Autologous CPCs are increasingly being used as a source of haematopoietic stem cells following HDC for solid tumours because of their ease of collection and the faster neutrophil and platelet recovery as compared with marrow (Siena et al, 1994). Besides, CPCs are less likely to be contaminated by tumour cells capable of clonogenic growth in vitro (Ross et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

“…An adequate number of progenitor cells capable of guaranteeing short-and long-term haematopoiesis can be harvested from the peripheral blood after treatment with haematopoietic growth factors administered as single agents or, more frequently, following myelosuppressive chemotherapy (Bensinger et al, 1993;Siena et al, 1994). Moreover, mobilization with disease-oriented chemotherapy in addition to cytokines is particularly recommended in patients with chemosensitive neoplasms as the greater efficacy of mobilization is combined with the anti-tumour effect of the drug.…”

mentioning

confidence: 99%

Collection of circulating progenitor cells after epirubicin, paclitaxel and filgrastim in patients with metastatic breast cancer

Pedrazzoli

Perotti²,

Prada³

et al. 1997

Br J Cancer

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Summary The efficacy of high-dose chemotherapy (HDC) and circulating progenitor cell (CPC) transplantation in metastatic breast cancer (MBC) relies mainly on giving this treatment after a response to conventional induction chemotherapy has been achieved. For this reason an optimal mobilization regimen should be therapeutically effective while minimizing the number of leucaphereses required to support the myeloablative therapy. The combination of an anthracycline and paclitaxel in chemotherapy-untreated MBC has produced impressive response rates. We evaluated the CPC-mobilizing capacity of the combination epirubicin (90 mg m-2) and paclitaxel (135 mg m-2) followed by filgrastim (5 Ag kg-1 day-1) starting 48 h after chemotherapy administration in ten patients with MBC who were eligible for an HDC and CPC transplantation programme. Leucaphereses were performed by processing at least two blood volumes per procedure at recovery from neutrophil nadir when CD34+ cells in the peripheral blood exceeded 20 [I-. In most patients (six out of 10) more than 2.5 x 106 CD34+ cells kg-', a threshold considered to be sufficient for haematopoietic reconstitution, were collected with a single apheresis. In the remaining four patients an additional procedure, performed the following day, was enough to reach the required number of progenitors. These data suggest that the epirubicin-paclitaxel combination, besides being a very active regimen in MBC, is effective in releasing large amounts of progenitor cells into circulation.Keywords: progenitor cell; mobilization; breast cancer; chemotherapyThe autologous transfusion of circulating progenitor cells (CPCs) collected from the peripheral blood by leucapheresis is rapidly replacing autologous bone marrow transplantation to support haematopoiesis after high-dose chemotherapy (HDC) for lymphoma and solid tumours (Gianni AM, 1994;Holoyake, 1994). The main reason for the success of this procedure is the capability of CPCs to produce a much faster haematopoietic recovery than bone marrow cells (Siena et al, 1989;Sheridan et al, 1992;Chao et al, 1993;Schmitz et al, 1996).An adequate number of progenitor cells capable of guaranteeing short-and long-term haematopoiesis can be harvested from the peripheral blood after treatment with haematopoietic growth factors administered as single agents or, more frequently, following myelosuppressive chemotherapy (Bensinger et al, 1993;Siena et al, 1994). Moreover, mobilization with disease-oriented chemotherapy in addition to cytokines is particularly recommended in patients with chemosensitive neoplasms as the greater efficacy of mobilization is combined with the anti-tumour effect of the drug. In fact, in most CPC transplantation programmes the mobilizing regimens include agents (often at high doses) with proven efficacy against the underlying disease (Brugger et al, 1992;Shimazaki et al, 1992;Gianni AM et al, 1995 Controversy still surrounds the use of HDC with CPC support in stage IV breast cancer (Shpall et al, 1994;Hortobagyi, 1995;Kennedy, 1995), mai...

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Durability of hematopoiesis following autografting with peripheral blood hematopoietic progenitors

Cited by 54 publications

References 20 publications

Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990–1999

Autologous hematopoietic stem cell transplantation for breast cancer in Europe: critical evaluation of data from the European Group for Blood and Marrow Transplantation (EBMT) Registry 1990–1999

The role of granulocyte colony-stimulating factor (G-CSF) in the post-transplant period

Collection of circulating progenitor cells after epirubicin, paclitaxel and filgrastim in patients with metastatic breast cancer

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