More efficient mobilisation of peripheral blood stem cells with HiDAC+AMSA+G-CSF than with mini-ICE+G-CSF in patients with AML

Bone Marrow Transplant. 2003 Dec;32(12):1119-24. doi: 10.1038/sj.bmt.1704294.

Abstract

We have compared the efficacy of two PBSC mobilisation regimens, mini-ICE+filgrastim (second consolidation) and HiDAC+AMSA+filgrastim (third consolidation), in two consecutive cohorts of patients with AML CR1 receiving treatment according to a joint protocol. Group A: 18 patients, aged 41 (21-65) years, were mobilised with mini-ICE (idarubicin 8 mg/m(2)+cytarabine 800 mg/m(2)+etoposide 150 mg/m(2) days 1-3) followed by filgrastim 300-480 microg once daily s.c. from day 11 after start of chemotherapy. Only four patients reached >5 CD34+ cells/microl blood (B-CD34+) and were able to undergo leukaphereses. Two out of 18 (11%) reached the defined target of >/=2.0 x 10(6) CD34+ cells/kg after 1-3 leukaphereses. Group B: 20 patients, aged 50 (29-67) years, received HiDAC+AMSA (cytarabine 3 g/m(2) b.i.d. days 1, 3, 5+amsacrine 150 mg/m(2) q.d. days 2, 4) followed by filgrastim at a similar dose starting on day 7. A total of 18 patients reached B-CD34+ >5/microl and underwent PBSC harvesting, starting on day 23 (14-29) and yielding 4.0 (0.9-21) x 10(6) CD34+ cells/kg. Of 20 patients, 17 (85%) reached the defined target of >/=2.0 x 10(6) CD34+ cells/kg after 1-3 leukaphereses. We conclude that HiDAC+AMSA+G-CSF - in contrast to mini-ICE+G-CSF - is an efficient regimen for mobilising PBSC in patients with AML CR1.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Amsacrine / administration & dosage
  • Amsacrine / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blood Cell Count
  • Caspase 14
  • Caspases / administration & dosage
  • Caspases / pharmacology*
  • Cohort Studies
  • Combined Modality Therapy
  • Cytarabine / administration & dosage
  • Cytarabine / pharmacology*
  • Etoposide / administration & dosage
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Idarubicin / administration & dosage
  • Idarubicin / adverse effects
  • Leukapheresis
  • Leukemia, Myeloid / blood*
  • Leukemia, Myeloid / drug therapy
  • Leukemia, Myeloid / therapy
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation
  • Recombinant Proteins
  • Transplantation, Autologous

Substances

  • Recombinant Proteins
  • Amsacrine
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • CASP14 protein, human
  • Caspase 14
  • Caspases
  • Filgrastim
  • Idarubicin

Supplementary concepts

  • ACE protocol 2