Retrospective comparison of mobilization methods for autologous stem cell transplantation in multiple myeloma.
The combination of cyclophosphamide and granulocyte-colony stimulating factor (G-CSF) has widely been used to mobilize hematopoietic stem cells (HSCs) for autologous stem cell transplantation (ASCT) for multiple myeloma (MM). Recently, however, alternative approaches such as G-CSF alone or etoposide followed by G-CSF have been investigated. We, therefore, retrospectively analyzed the effects of these mobilization methods on collection yield and disease outcome in ASCT for MM. We reviewed 146 MM patients from whom we intended to collect stem cells. For mobilization, 67, 58, and 21 patients received cyclophosphamide and G-CSF, etoposide and G-CSF, and G-CSF alone (including nonmyelosuppressive chemotherapy followed by G-CSF), respectively. Among them, 136 achieved the target number of HSCs (at least 2 x 10(6)/kg). Lower creatinine and higher albumin levels at diagnosis were significantly associated with successful yield. A lower number of infused HSCs, use of the etoposide for mobilization and high ISS were associated with delayed hematopoietic recovery. The mobilization methods did not significantly affect either the successful collection of more than 2 x 10(6) CD34-positive cells/kg or PFS after ASCT. G-CSF alone was sufficient for stem cell mobilization for a single ASCT. The optimal approach to collect HSCs in MM remains to be elucidated.
Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Saitama, Japan.
Hideki
H
Nakasone
Yoshinobu
Y
Kanda
Tomoki
T
Ueda
Kenji
K
Matsumoto
Naomi
N
Shimizu
Jiro
J
Minami
Rika
R
Sakai
Maki
M
Hagihara
Akira
A
Yokota
Kumi
K
Oshima
Yuiko
Y
Tsukada
Takayoshi
T
Tachibana
Chiaki
C
Nakaseko
Shin
S
Fujisawa
Shingo
S
Yano
Hiroyuki
H
Fujita
Satoshi
S
Takahashi
Heiwa
H
Kanamori
Shinichiro
S
Okamoto
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002452:Cell Count; D003131:Combined Modality Therapy; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology; D018572:Disease-Free Survival; D004357:Drug Synergism; D005047:Etoposide / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D000078224:Lenograstim; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D011994:Recombinant Proteins; D012709:Serum Albumin; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D000078224:Lenograstim; D003520:Cyclophosphamide; D003404:Creatinine; D000069585:Filgrastim