Mobilization of peripheral blood progenitor cells after induction chemotherapy (THP-doxorubicin-vinorelbine-cyclophosphamide-fluorouracil) and granulocyte colony-stimulating factor in breast cancer

Abstract

Summary:In order to evaluate the mobilization of peripheral blood progenitor cells (PBPC) after an effective induction regimen in breast cancer, we performed a study on 15 breast cancer patients. Between January 1995 and June 1996, these patients received TNCF (THP-doxorubicin, vinorelbine, cyclophosphamide, fluorouracil for four days, every 21 days) with G-CSF support (5 g/kg for 10 days after chemotherapy) to reduce aplasia. This regimen is known to result in a complete pathological response in 30% of patients. Between two cycles of TNCF treatment, hematological recovery was observed. Progenitor cells (CFU-GM and CD34 ؉ cells) and mononuclear cells in DNA synthesis (MCDS) counts were performed daily, between the 12th and 17th postchemotherapy days (81 samples). The results showed a similarity for hematological recovery and PBPC mobilization kinetics depending on the number of treatment cycles. The three methods used for PBPC evaluation were well correlated (P Ͻ 0.01) with an optimal mean PBPC recruitment by the last day of G-CSF administration: respectively, 11 520 (1729-26 539) CFU-GM/ml of blood, 249 (14-1160) CD34 ؉ cells/ l of blood and 211 (21-554) MCDS/ l of blood. These results suggested that a daily injection of G-CSF after one or two TNCF cycles will produce an effective PBPC mobilization in comparison with currently used regimens.

Hematological recovery and peripheral blood progenitor cell mobilization after induction chemotherapy and GM-CSF plus G-CSF in breast cancer

“…Studies in vitro have shown that GM-CSF acts earlier than G-CSF. 15,16 In a previous study, we have shown a specific cytotoxic effect on breast tumor 21 and at the same time, mobilization of PBPC 20 after TNCF treatment and G-CSF. In the present work, we looked for a synergistic effect of GM-CSF and G-CSF to improve hematological recovery between two TNCF cycles and to mobilize a sufficient number of PBPCs in one leukapheresis.…”

“…Indeed, our results were two-to three-fold greater than those obtained with different mobilization regimens in breast cancer. 20,[27][28][29][30] …”

“…We have chosen TNCF chemotherapy, which exhibits both mobilizing 20 and specific cytotoxic 21 effects. We tested 43 patients with the TNCF regimen and studied PBPC mobilization and hematological recovery for 5 days, beginning when there were more than 1.0 × 10 9 leukocytes/l of blood.…”

Change in CD34+ cell concentration during peripheral blood progenitor cell collection: effects on collection efficiency and efficacy

“…where E is the efficiency of CD34+ cell collection and C is CD34 level available to the apheresis instrument. Published data suggest that, during the initial phase of mobilization, A can be modeled by an exponential function 2,3 . The primary variables, then, which determine the number of CD34+ cells collected during a procedure are the number of BVs processed, the collection efficiency (at any given set of collection parameters), and the CD34 concentration available to the apheresis instrument, which depends upon a dynamic relationship between the mobilization and extraction of CD34+ cells.…”

Kinetics of PBPC mobilization by cyclophosphamide, as compared with that by epirubicin/paclitaxel followed by G–CSF support: implications for optimal timing of PBPC harvest

“…Breast cancer represents one of the most frequent disease entities treated with autologous PBPC transplantation, 1 although, in view of recent clinical results, the frequency of PBPC harvest in breast cancer patients may decrease in future 9 . Cyclophosphamide (CY) followed by the administration of G–CSF is a frequently applied protocol for PBPC mobilization in breast cancer 10,11 . Other regimens consisting of different cytoreductive agents have also been successfully used for PBPC mobilization 12,13 .…”