Optimal chemo-mobilization for the collection of peripheral blood stem cells in patients with multiple myeloma View Full Text


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Article Info

DATE

2019-12

AUTHORS

Ga-Young Song, Sung-Hoon Jung, Seo-Yeon Ahn, Seung-Yeon Jung, Deok-Hwan Yang, Jae-Sook Ahn, Hyeoung-Joon Kim, Je-Jung Lee

ABSTRACT

BACKGROUND: For successful autologous stem cell transplantation, the collection of a sufficient number of hematopoietic stem cells after induction therapy is essential for transplant candidates with multiple myeloma (MM). METHODS: In this study, we compared the efficacy and safety of stem cell mobilization using cyclophosphamide (CY; 3.0 g/m2 on day 1) or etoposide (VP-16; 375 mg/m2 on days 1 and 2) in patients with MM. Granulocyte-colony stimulating factor (G-CSF, 10 μg/kg/day, subcutaneously) was administered from the onset of neutropenia to the final day of collection. RESULTS: Sixty-five patients were mobilized with a combination of CY and G-CSF, and 63 were mobilized with a combination of VP-16 and G-CSF. All patients were mobilized within 7 months of beginning frontline treatment. The median number of CD34+ cells collected was significantly higher in the VP-16 mobilization group than in the CY mobilization group (27.6 × 106 CD34+/kg vs. 9.6 × 106 CD34+/kg, P < 0.001). The rate of mobilization failure, defined as < 2.0 × 106 CD34+/kg collected in three apheresis procedures, was lower in the VP-16 group than in the CY group (1.6% vs. 10.8%, P = 0.062). Severe infections during the mobilization period were more frequent in the CY group than in the VP-16 group (18.5% vs. 7.9%, P = 0.117). CONCLUSION: In conclusion, an intermediate dose of VP-16 with G-CSF appears to be an effective and tolerable chemo-mobilization method compared to CY and G-CSF, particularly in cases where use plerixafor in MM is difficult. More... »

PAGES

59

References to SciGraph publications

  • 2011-01. Plerixafor plus granulocyte CSF can mobilize hematopoietic stem cells from multiple myeloma and lymphoma patients failing previous mobilization attempts: EU compassionate use data in BONE MARROW TRANSPLANTATION
  • 2009-04. Comparison of high-dose CY and growth factor with growth factor alone for mobilization of stem cells for transplantation in patients with multiple myeloma in BONE MARROW TRANSPLANTATION
  • 2013-06. Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT in BONE MARROW TRANSPLANTATION
  • 1999-10. Factors influencing G-CSF-mediated mobilization of hematopoietic progenitor cells during steady-state hematopoiesis in patients with malignant lymphoma and multiple myeloma in ANNALS OF HEMATOLOGY
  • 2013-10. Comparable efficacy and lower cost of PBSC mobilization with intermediate-dose cyclophosphamide and G-CSF compared with plerixafor and G-CSF in patients with multiple myeloma treated with novel therapies in BONE MARROW TRANSPLANTATION
  • 1999-06. Successful peripheral blood stem cell mobilization with etoposide (VP-16) in patients with relapsed or resistant lymphoma who failed cyclophosphamide mobilization in BONE MARROW TRANSPLANTATION
  • 2004-05. Prediction of mobilisation failure in patients with non-Hodgkin's lymphoma in BONE MARROW TRANSPLANTATION
  • 2013-01. Efficacy of stem cell mobilization in patients with newly diagnosed multiple myeloma after a CTD (cyclophosphamide, thalidomide, and dexamethasone) regimen in INTERNATIONAL JOURNAL OF HEMATOLOGY
  • 1999-05. Management strategies for the hard-to-mobilize patient in BONE MARROW TRANSPLANTATION
  • 2010-01. Safety and preliminary efficacy of plerixafor (Mozobil) in combination with chemotherapy and G-CSF: an open-label, multicenter, exploratory trial in patients with multiple myeloma and non-Hodgkin's lymphoma undergoing stem cell mobilization in BONE MARROW TRANSPLANTATION
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1186/s12885-019-5285-1

    DOI

    http://dx.doi.org/10.1186/s12885-019-5285-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111406309

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30642286


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        "description": "BACKGROUND: For successful autologous stem cell transplantation, the collection of a sufficient number of hematopoietic stem cells after induction therapy is essential for transplant candidates with multiple myeloma (MM).\nMETHODS: In this study, we compared the efficacy and safety of stem cell mobilization using cyclophosphamide (CY; 3.0\u2009g/m2 on day 1) or etoposide (VP-16; 375\u2009mg/m2 on days 1 and 2) in patients with MM. Granulocyte-colony stimulating factor (G-CSF, 10\u2009\u03bcg/kg/day, subcutaneously) was administered from the onset of neutropenia to the final day of collection.\nRESULTS: Sixty-five patients were mobilized with a combination of CY and G-CSF, and 63 were mobilized with a combination of VP-16 and G-CSF. All patients were mobilized within 7\u2009months of beginning frontline treatment. The median number of CD34+ cells collected was significantly higher in the VP-16 mobilization group than in the CY mobilization group (27.6\u2009\u00d7\u2009\u00a0106 CD34+/kg vs. 9.6\u2009\u00d7\u2009106 CD34+/kg, P\u2009<\u2009\u00a00.001). The rate of mobilization failure, defined as <\u20092.0\u2009\u00d7\u2009106 CD34+/kg collected in three apheresis procedures, was lower in the VP-16 group than in the CY group (1.6% vs. 10.8%, P\u2009=\u20090.062). Severe infections during the mobilization period were more frequent in the CY group than in the VP-16 group (18.5% vs. 7.9%, P\u2009=\u20090.117).\nCONCLUSION: In conclusion, an intermediate dose of VP-16 with G-CSF appears to be an effective and tolerable chemo-mobilization method compared to CY and G-CSF, particularly in cases where use plerixafor in MM is difficult.", 
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    33 schema:description BACKGROUND: For successful autologous stem cell transplantation, the collection of a sufficient number of hematopoietic stem cells after induction therapy is essential for transplant candidates with multiple myeloma (MM). METHODS: In this study, we compared the efficacy and safety of stem cell mobilization using cyclophosphamide (CY; 3.0 g/m2 on day 1) or etoposide (VP-16; 375 mg/m2 on days 1 and 2) in patients with MM. Granulocyte-colony stimulating factor (G-CSF, 10 μg/kg/day, subcutaneously) was administered from the onset of neutropenia to the final day of collection. RESULTS: Sixty-five patients were mobilized with a combination of CY and G-CSF, and 63 were mobilized with a combination of VP-16 and G-CSF. All patients were mobilized within 7 months of beginning frontline treatment. The median number of CD34+ cells collected was significantly higher in the VP-16 mobilization group than in the CY mobilization group (27.6 ×  106 CD34+/kg vs. 9.6 × 106 CD34+/kg, P <  0.001). The rate of mobilization failure, defined as < 2.0 × 106 CD34+/kg collected in three apheresis procedures, was lower in the VP-16 group than in the CY group (1.6% vs. 10.8%, P = 0.062). Severe infections during the mobilization period were more frequent in the CY group than in the VP-16 group (18.5% vs. 7.9%, P = 0.117). CONCLUSION: In conclusion, an intermediate dose of VP-16 with G-CSF appears to be an effective and tolerable chemo-mobilization method compared to CY and G-CSF, particularly in cases where use plerixafor in MM is difficult.
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