[Dose escalation study of high dose etoposide in autologous hematopoietic stem cell transplantation]

Eight cases with poor prognosis hematological malignancies (non-Hodgkin lymphoma, 6 cases; acute non-lymphocytic leukemia, 2 cases) and nine cases with non-hematological malignancies were treated with high dose etoposide (VP16) containing regimen followed by autologous hemopoietic stem cell transplantation. Results were as follows; 1) all of three chemotherapy sensitive relapse patients with hematological malignancies continue complete remission without any cyto-reductive therapy 2) one of four refractory relapse patients continue remission 3) partial anti-tumor effect was noted in non-hematological malignancies, however, only two cases continue complete remission. Remission duration of other responders was not so long. The results disclosed the dose-limiting factor of high-dose VP16 therapy as reversible stomatitis with no related mortality, and maximal tolerated dose appears to be 60 mg/kg over 72 hr with 45 mg/kg as a safe and recommended therapeutic dose in future clinical trial. The clinical effect of dose escalation was not clearly demonstrated.