Docetaxel effectively mobilizes peripheral blood CD34⁺ cells

Abstract

We prospectively evaluated docetaxel (100 mg/m²) with g-csf (10 μg/kg s.c., daily) for mobilization efficiency in 26 patients with breast cancer. the minimum target yield was >4.5 × 10⁶ CD34⁺ cells/kg (optimum = 9 × 10⁶/kg), sufficient to support the subsequent three cycles of high-dose therapy (HDT). The peak days for peripheral blood (PB) CD34⁺ cells were day 8 and day 9. Seven collections began on day 7, 16 on day 8 and three on day 9. The median peripheral blood progenitor cell (PBPC) CD34⁺ cell content ranged from 1.2 to 5.9 × 10⁶/kg per day during days 7 to 11 with a median CD34⁺ content of the total 72 PBPC collections of 3.4 × 10⁶/kg (0.07–15.6). Fifteen patients obtained a PBPC collection exceeding 5 × 10⁶/kg on a single day of collection. Following a median 3 days collection for each patient (range 2–4), the median total CD34⁺ for all individual sets of collections was 9.7 × 10⁶/kg (range 1.0–28.4). We were able to achieve the minimum CD34⁺ cell target yield in 22 of 26 patients with one cycle of mobilisation chemotherapy and in two of these patients a second collection yielded sufficient cells. twenty-two patients have subsequently received repetitive hdt and pbpc transplantation with 57 cycles of hdt having been delivered. for all 57 cycles, the median time to absolute neutrophil count (anc) >0.5 × 10⁹/l and 1.0 × 10⁹/l was 10 days (range 8–22) and 11 days (range 8–23), respectively. The median time to platelets greater than 20 × 10⁹/l, 50 × 10⁹/l and 100 × 10⁹/l was 13 days (range 11–23), 17 days (range 12–53) and 23 days (range 18–70), respectively. We conclude that docetaxel with G-CSF effectively mobilises PBPCs with apheresis needing to be commenced approximately 8 days after docetaxel administration. Bone Marrow Transplantation (2000) 26, 483–487.