Topotecan-filgrastim combination is an effective regimen for mobilizing peripheral blood stem cells

E. J.A. Yeoh, J. M. Cunningham, G. C. Yee, D. Hunt, J. A. Houston, S. L. Richardson, C. F. Stewart, P. J. Houghton, L. C. Bowman, A. J. Gajjar

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

We compared the efficacy, toxicity, and cost of topotecan-filgrastim and filgrastim alone for mobilizing peripheral blood stem cells (PBSCs) in 24 consecutive pediatric patients with newly diagnosed medulloblastoma. PBSCs were mobilized with an upfront window of topotecan-filgrastim for 11 high-risk patients (residual tumor ≥1.5 cm2 after resection; metastases limited to neuraxis) and with filgrastim alone for 13 average-risk patients. All patients subsequently underwent craniospinal irradiation and four courses of high-dose chemotherapy with stem cell rescue. Target yields of CD34+ cells (≥8 × 106/kg) were obtained with only one apheresis procedure for each of the 11 patients treated with topotecan-filgrastim, but with a mean of 2.3 apheresis procedures for only six (46%) of the 13 patients treated with filgrastim alone (P = 0.0059). The median peak and median total yield of CD34+ cells were six-fold higher for the topotecan-filgrastim group (328/μl and 21.5 × 106/kg, respectively) than for the filgrastim group (54/μl and 3.7 × 106/kg, respectively). Mean times to neutrophil and platelet engraftment were similar. Myelosuppression was the only grade 4 toxicity associated with topotecan-filgrastim mobilization and lasted a median of 5 days. Compared with filgrastim mobilization, topotecan-filgrastim mobilization resulted in a mean cost saving of $3966 per patient. Topotecan-filgrastim is an efficacious, minimally toxic, and cost-saving combination for PBSC mobilization.

Original languageEnglish (US)
Pages (from-to)563-571
Number of pages9
JournalBone marrow transplantation
Volume28
Issue number6
DOIs
StatePublished - Oct 29 2001

    Fingerprint

Keywords

  • Children
  • Filgram
  • High-dose chemotherapy
  • Medulloblastoma
  • Peripheral blood stem cell
  • Topotecan

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Yeoh, E. J. A., Cunningham, J. M., Yee, G. C., Hunt, D., Houston, J. A., Richardson, S. L., Stewart, C. F., Houghton, P. J., Bowman, L. C., & Gajjar, A. J. (2001). Topotecan-filgrastim combination is an effective regimen for mobilizing peripheral blood stem cells. Bone marrow transplantation, 28(6), 563-571. https://doi.org/10.1038/sj.bmt.1703202