Faculty Collaboration Database

Dose-intensification of procarbazine, CCNU (lomustine), vincristine (PCV) with peripheral blood stem cell support in young patients with gliomas. Med Pediatr Oncol 1998 Dec;31(6):483-90

Date

12/04/1998

Pubmed ID

9835900

DOI

10.1002/(sici)1096-911x(199812)31:6<483::aid-mpo4>3.0.co;2-9

Scopus ID

2-s2.0-0031785402 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: The regimen of procarbazine, CCNU, and vincristine is active against gliomas. Previous attempts at dose-intensification have been unsuccessful because of delayed and cumulative myelosuppression. We sought to determine whether peripheral blood stem cell (PBSC) infusions would allow dose-escalation and time compression.

PROCEDURE: Eleven patients, age 2.8-35.9 years, with newly diagnosed (n = 10) or recurrent (n = 1) gliomas underwent PBSC harvesting after mobilization with G-CSF. Chemotherapy consisted of CCNU 130 mg/m2 on day 0, vincristine 1.5 mg/m2 on days 0 and 7, and procarbazine 150 mg/m2 on days 1-7. PBSCs were reinfused on day 9 of each course. Four courses of chemotherapy were administered 28 days apart or when counts recovered. Involved field radiation was administered to newly diagnosed high-grade glioma patients following recovery from chemotherapy.

RESULTS: Compared to the standard PCV regimen given every 6 weeks, dose intensity received was 1.7- and 1.8-fold greater for CCNU and procarbazine. Chemotherapy was delivered on time in 33/41 (80.5%) courses. Four courses (9.8%) were complicated by absolute neutrophil counts < 200/microL; platelet nadirs < 50,000/microL occurred in two courses (4.9%). Fever with neutropenia complicated three courses. Eight of 9 patients with measurable disease had an objective decrease in tumor size and/or decreased enhancement. Median survival for patients with high-grade gliomas (n = 6) was 13 months.

CONCLUSIONS: Dose-intensification of PCV is possible using PBSCs.

Author List

Jakacki RI, Jamison C, Mathews VP, Heilman DK, Dropcho E, Cornetta K, Macdonald DR, Williams DA

Author

Vincent Mathews MD Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Child
Child, Preschool
Drug Administration Schedule
Female
Glioma
Hematopoietic Stem Cell Transplantation
Humans
Infant
Lomustine
Male
Procarbazine
Survival Analysis
Treatment Outcome
Vincristine