Abstract
Dose intensity has been related to clinical outcome in several solid tumors. We studied the influence of clinical and cellular parameters on dose intensity received in a series of 53 patients with metastatic breast cancer or advanced ovarian cancer. They received courses of cisplatin 120 mg/m2 plus etoposide 600 mg/m2 alternating every 14 days with ifosfamide 8 g/m2 plus paclitaxel 200–350 mg/m2. Blood stem cell support was administered after every course except for the first one. Patients with excellent mobilization underwent immunomagnetic selection of CD34+ cells. We found a significant inverse correlation between the CD34+ cell dose infused and the delay for the administration of the next cycle. A CD34+ cell dose between 1.5 and 5 × 106/kg per cycle was found to be feasible and was followed by a median delay of 1day (not different from doses above 5 × 106/kg). Three factors independently predicted the actually received dose intensity in a multiple regression model (R2 = 0.4): previous autologous transplantation, eligibility for immunomagnetic selection (excellent response to mobilization) and median CD34+ cell dose received along the treatment.