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

E. J A Yeoh, J. M. Cunningham, Gary 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

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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

Topotecan
Blood Component Removal
Costs and Cost Analysis
Peripheral Blood Stem Cells
Filgrastim
Craniospinal Irradiation
Hematopoietic Stem Cell Mobilization
Medulloblastoma
Poisons
Residual Neoplasm

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., ... 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

Topotecan-filgrastim combination is an effective regimen for mobilizing peripheral blood stem cells. / Yeoh, E. J A; Cunningham, J. M.; Yee, Gary C; Hunt, D.; Houston, J. A.; Richardson, S. L.; Stewart, C. F.; Houghton, P. J.; Bowman, L. C.; Gajjar, A. J.

In: Bone marrow transplantation, Vol. 28, No. 6, 29.10.2001, p. 563-571.

Research output: Contribution to journalArticle

Yeoh, EJA, Cunningham, JM, Yee, GC, Hunt, D, Houston, JA, Richardson, SL, Stewart, CF, Houghton, PJ, Bowman, LC & Gajjar, AJ 2001, 'Topotecan-filgrastim combination is an effective regimen for mobilizing peripheral blood stem cells', Bone marrow transplantation, vol. 28, no. 6, pp. 563-571. https://doi.org/10.1038/sj.bmt.1703202
Yeoh, E. J A ; Cunningham, J. M. ; Yee, Gary C ; Hunt, D. ; Houston, J. A. ; Richardson, S. L. ; Stewart, C. F. ; Houghton, P. J. ; Bowman, L. C. ; Gajjar, A. J. / Topotecan-filgrastim combination is an effective regimen for mobilizing peripheral blood stem cells. In: Bone marrow transplantation. 2001 ; Vol. 28, No. 6. pp. 563-571.
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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.",
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AU - Houston, J. A.

AU - Richardson, S. L.

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