High-dose etoposide phosphate and G-CSF mobilizes peripheral blood stem cells in patients that previously failed to mobilize

Abstract

 Ten consecutive patients in our unit who had failed to mobilize a sufficient stem cell yield after either an initial or several mobilization regimens received high-dose etoposide phosphate (1500–2000 mg/m²) followed by granulocyte colony-stimulating factor (G-CSF; 10 μg/kg per day) to stimulate mobilization. Eight of the ten patients were apheresed. A median of 2.1×10⁶ CD34+/kg (range 0–5.2) was collected. The number of CD34+ cells/μl peripheral blood (pB) was significantly increased compared to the first-line mobilization [median 13.0 (range 2.68–29) versus median 4.76 (range 1.36–12);P<0.05]. Besides hematotoxicity and four cases of infection (WHO grade 3), no major side effects were seen. The median duration of neutropenia was short (5 days, range 0–10), which is important in heavily pretreated patients. These results indicate that high-dose etoposide phosphate with G-CSF is safe, well tolerated, and may be effective in peripheral blood stem cell (PBSC) mobilization in patients who had previously failed to mobilize.