Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation

• Published in: Bone marrow transplantation (Basingstoke) Vol. 50; no. 12; pp. 1513 - 1518
• Main Authors: Uy, G L, Costa, L J, Hari, P N, Zhang, M-J, Huang, J-X, Anderson, K C, Bredeson, C N, Callander, N S, Cornell, R F, Perez, M A D, Dispenzieri, A, Freytes, C O, Gale, R P, Garfall, A, Gertz, M A, Gibson, J, Hamadani, M, Lazarus, H M, Kalaycio, M E, Kamble, R T, Kharfan-Dabaja, M A, Krishnan, A Y, Kumar, S K, Kyle, R A, Landau, H J, Lee, C H, Maiolino, A, Marks, D I, Mark, T M, Munker, R, Nishihori, T, Olsson, R F, Ramanathan, M, Rodriguez, T E, Saad, A A, Savani, B N, Schiller, G J, Schouten, H C, Schriber, J R, Scott, E, Seo, S, Sharma, M, Ganguly, S, Stadtmauer, E A, Tay, J, To, L B, Vesole, D H, Vogl, D T, Wagner, J L, Wirk, B, Wood, W A, D'Souza, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2015; Nature Publishing Group
• Subjects: 631/67/1990/804; 692/699/1541/1990/804; Adolescent; Adult; Aged; Autografts; Blood; Bone marrow; Care and treatment; Cell Biology; Cells (biology); Chemotherapy; Confidence intervals; Cytotoxicity; Disease control; Disease-Free Survival; Female; Growth factors; Hematology; Hematopoietic Stem Cell Mobilization - methods; Hematopoietic Stem Cell Transplantation; Hemopoiesis; Humans; Internal Medicine; Leukocyte Count; Leukocytes (neutrophilic); Male; Medical research; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Methods; Middle Aged; Multiple myeloma; Multiple Myeloma - blood; Multiple Myeloma - therapy; original-article; Patient outcomes; Peripheral blood; Platelet Count; Precision medicine; Progenitor cells; Prospective Studies; Public Health; Recovery of Function; Stem cell transplantation; Stem Cells; Survival Rate; Transplantation; Transplants & implants
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2015.190

In patients with multiple myeloma (MM) undergoing autologous hematopoietic cell transplantation (auto-HCT), peripheral blood progenitor cells may be collected following mobilization with growth factor alone (GF) or cytotoxic chemotherapy plus GF (CC+GF). It is uncertain whether the method of mobilization affects post-transplant outcomes. We compared these mobilization strategies in a retrospective analysis of 968 patients with MM from the Center for International Blood and Marrow Transplant Research database who received an auto-HCT in the US and Canada between 2007 and 2012. The kinetics of neutrophil engraftment (⩾0.5 × 10 9 /L) was similar between groups (13 vs 13 days, P =0.69) while platelet engraftment (⩾20 × 10 9 /L) was slightly faster with CC+GF (19 vs 18 days, P =0.006). Adjusted 3-year PFS was 43% (95% confidence interval (CI) 38–48) in GF and 40% (95% CI 35–45) in CC+GF, P =0.33. Adjusted 3-year OS was 82% (95% CI 78–86) vs 80% (95% CI 75–84), P =0.43 and adjusted 5-year OS was 62% (95% CI 54–68) vs 60% (95% CI 52–67), P =0.76, for GF and CC+GF, respectively. We conclude that MM patients undergoing auto-HCT have similar outcomes irrespective of the method of mobilization and found no evidence that the addition of chemotherapy to mobilization contributes to disease control.