Quimioterapia intensiva con 1-3 fármacos y soporte con células mielopoyéticas autologas extraídas de la sangre periférica: resultados preliminares

Fourteen patients with different salid tumors have been treated with high-dose combination chemotherapy followed by autologous PBSC support. A total of 15 procedures have been done. 4,5-7 x 10' 0 mononuclear cells were obtained through 1-4 leukopheresis using a CS-3.000 continuous flow blood cell separator. Cells were mantained in standard culture conditions for 3-5 days prior to infusion. Chemotherapy consisted in the administration of 1-3 agents: CPA 80 mg/kg; VP-16, 800 mg/m2; BCNU 700-800 mg/m2, CBDCA 1.000 mg/m2. APBSC were infused 48 hours after the last chemotherapy was given. Patients were maintained in single bed rooms with standard prophylactic antibiotics, including gentamycin, piperacillin, vancomycin and amphotericin B during the period of aplasia. Currently 5 procedures are available for response and ali patients are evaluable for toxicity. Responses have been: 2 complete responses and 3 partial response. Ali patients entered in aplasia, with 12 infections (73 % ), 8 bleeding (53 % ), 4 diarrhea (27 % ), 2 stomatitis (13 % ) and 3 renal failure (16 % ). Conclusions: 1. Bone marrow recovery after high dose chemotherapy can be shortened with APBSC support. 2. APBSC can be safely maintained using standard culture techniques, thus avoiding the freezing procedure.