Cyclophosphamide plus granulocyte-colony stimulating factor for hematopoietic stem cell mobilization in patients with multiple myeloma.
We retrospectively reviewed the results of cyclophosphamide (3 g/m(2) ), doxorubicin and dexamethasone plus granulocyte-colony stimulating factor (G-CSF) (ID-CY/DOX group), low-dose cyclophosphamide (2 g/m(2) ) plus G-CSF (LD-CY group) and G-CSF alone (G-CSF group) for stem cell mobilization in patients with multiple myeloma. A total of 89 patients with 93 mobilizations were included. Apheresis was started when total white blood cell (WBC) count >10 × 10(9) /L for ID-CY/DOX and LD-CY groups and after eight doses of G-CSF (5 μg/kg twice daily) for G-CSF group. For five mobilizations in ID-CY/DOX group, the rate of successful mobilization (≥4.0 × 10(6) /kg CD34+ cells) was 80%. For 78 mobilizations in LD-CY group, the successful rate was 80.8%. For 10 mobilizations in the G-CSF group, the successful rate was 50%. The mean yield of CD34+ cells was higher in ID-CY/DOX and LD-CY groups as compared with that in G-CSF group (P = 0.026 and 0.020, respectively). There was no difference in the yield of CD34+ cells between ID-CY/DOX and LD-CY groups (P = 0.831). After autologous stem cell transplantation, the days to neutrophil and platelet engraftment were similar in these three groups (P = 0.713 and 0.821, respectively). In conclusion, we observed that ID-CY/DOX and LD-CY plus G-CSF for stem cell mobilization resulted in a higher successful rate and higher stem cell yields than G-CSF alone and their engraftment time were similar. Total WBC count >10 × 10(9) /L can be used as a guide to start apheresis in CY-based stem cell mobilization. J. Clin. Apheresis 31:423-428, 2016. © 2015 Wiley Periodicals, Inc.
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Tung-Liang
TL
Lin
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan. dwang1415@gmail.com.
Po-Nan
PN
Wang
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.|College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Ming-Chung
MC
Kuo
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Yu-Hsing
YH
Hung
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.|College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Hung
H
Chang
Department of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.|College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Tzung-Chih
TC
Tang
D018952:Antigens, CD34 / Q000032:analysis; D003520:Cyclophosphamide / Q000627:therapeutic use*; D003907:Dexamethasone; D004317:Doxorubicin; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007937:Leukapheresis / Q000379:methods; D009101:Multiple Myeloma / Q000628:therapy*; D012189:Retrospective Studies; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide
autologous hematopoietic stem cell transplantation; cyclophosphamide; granulocyte-colony stimulating factor; hematopoietic stem cell mobilization; multiple myeloma