title: The effect of gradual increment in rhG-CSF dose on stem cell yields in patients with multiple myeloma mobilized with intermediate dose cyclophosphamide plus rhG-CSF.
abstract: Cyclophosphamide along with recombinant human granulocyte-colony stimulating factor (rhG-CSF) is a commonly used strategy for mobilization. However, the optimal timing for rhG-CSF initiation after cyclophosphamide has not been determined as conclusively as has the G-CSF dose. In this paper, we aimed to present gradual dose increment of rhG-CSF between the third day of mobilization and time to apheresis that is started with 5 μg/kg (from day 3 to day 7) and continued with 10 μg/kg (from day 8 to time to apheresis) for peripheral blood stem cell (PBSC) mobilization in multiple myeloma (MM) patients and its effect on stem cell yield and mobilization success. Data from 30 consecutive patients with MM who underwent PBSC mobilization between October 2011 and June 2013, were retrospectively reviewed. While twenty-eight of 30 patients (93.3%) were successfully mobilized, 2 patients (6.7%) had mobilization failure. The final median CD34+ cell dose harvested from the patients was 9.5×10(6)/kg. The median number of apheresis was 2.5 (range, 0-3). Twenty-four patients (80%) yielded >2×10(6) CD34+ cells/kg in one apheresis procedure. In conclusion, our regimen might be used to decrease the mobilization failure regarding the low dose rhG-CSF use and provide a cost effective strategy.
authors.affiliation: Pamukkale University, Faculty of Medicine, Fahri Goksin Oncology Center, Department of Hematology, Therapeutic Apheresis Unit, TR-20070 Denizli, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Hacıoğlu
authors.affiliation: Pamukkale University, Faculty of Medicine, Fahri Goksin Oncology Center, Department of Hematology, Therapeutic Apheresis Unit, TR-20070 Denizli, Turkey. Electronic address: hisari@gmail.com.
authors.forename: Ismail
authors.initials: I
authors.lastname: Sarı
authors.affiliation: Pamukkale University, Faculty of Medicine, Fahri Goksin Oncology Center, Department of Hematology, Therapeutic Apheresis Unit, TR-20070 Denizli, Turkey.
authors.forename: Mehmet Hilmi
authors.initials: MH
authors.lastname: Doğu
authors.affiliation: Pamukkale University, Faculty of Medicine, Fahri Goksin Oncology Center, Department of Hematology, Therapeutic Apheresis Unit, TR-20070 Denizli, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Keskin
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001781:Blood Component Removal; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000191:economics / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide
keywords: Cyclophosphamide; Granulocyte colony stimulating factor; Multiple myeloma; Stem cell mobilization