Peripheral blood stem cell mobilization in multiple myeloma comparison of two consecutive regimens in a limited resources country

• Published in: Bone marrow transplantation (Basingstoke) Vol. 52; no. 2; pp. 222 - 227
• Main Authors: Ben Abdejlil, N, Belloumi, D, Mâammar, M, El Fatimi, R, Torjman, L, Lakhal, A, Jenhani, F, Hmida, S, Ben Othman, T, Ladeb, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2017; Nature Publishing Group
• Subjects: 13; 13/100; 13/31; 631/532/1542; 692/700/565; Adult; Aged; Allografts; Antibiotics; Autografts; Blood; Blood transfusion; Bone marrow; Care and treatment; CD34 antigen; Cell Biology; Cyclophosphamide; Cyclophosphamide - administration & dosage; Diagnosis; Erythrocytes; Female; Granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - administration & dosage; Hematology; Hematopoietic Stem Cell Mobilization - methods; Hematopoietic stem cells; Humans; Internal Medicine; Leukocytes (neutrophilic); Male; Medicine; Medicine & Public Health; Middle Aged; Multiple myeloma; Multiple Myeloma - therapy; Neutropenia; original-article; Patients; Peripheral blood; Peripheral Blood Stem Cell Transplantation; Public Health; Recovery; Red blood cells; Stem cell transplantation; Stem Cells; Toxicity; Transfusion; Transplantation; VP16 protein
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2016.246

This study compared retrospectively the effectiveness, toxicity and hematopoietic recovery after autologous peripheral blood stem cell transplantation (ASCT) of two consecutive peripheral blood stem cell mobilization regimens in newly diagnosed MM patients. Patients in group 1 ( n =178) were treated with 4 g/m 2 of cyclophosphamide (CY) plus G-CSF (5 μg/kg/day). Patients in group 2 ( n =117) with 750 mg/m 2 of VP16 plus G-CSF (10 μg/kg/day). Optimal mobilization, defined by a target number of 8 × 10 6 CD34+ cells/kg collected, was achieved in 62.4% and 89.7% of patients in groups 1 and 2, respectively ( P <10 −4 ). The median number of aphaeresis sessions was reduced from two in group 1 to one in group 2 ( P <10 −4 ). Grade 4 neutropenia, febrile neutropenia and IV antibiotic use were significantly more frequent in group 1 than in group 2 ( P <10 −4 ). Red blood cell transfusion requirements were significantly greater in group 1 ( P =0.007). The switch to VP16-G-CSF 10 resulted in a significant reduction of the number of hospitalization days ( P <10 −4 ). Neutrophil and platelet recovery after ASCT occurred on days 11 and 12, respectively, in the two groups with no significant differences. VP 16 +G-CSF 10 allowed liberation of resources in the clinical and aphaeresis departments and demonstrated a better effectiveness-safety profile than CY+G-CSF 5 .