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Retrospective comparison of mobilization methods for autologous stem cell transplantation in multiple myeloma
Author(s) -
Nakasone Hideki,
Kanda Yoshinobu,
Ueda Tomoki,
Matsumoto Kenji,
Shimizu Naomi,
Minami Jiro,
Sakai Rika,
Hagihara Maki,
Yokota Akira,
Oshima Kumi,
Tsukada Yuiko,
Tachibana Takayoshi,
Nakaseko Chiaki,
Fujisawa Shin,
Yano Shingo,
Fujita Hiroyuki,
Takahashi Satoshi,
Kanamori Heiwa,
Okamoto Shinichiro
Publication year - 2009
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.21552
Subject(s) - multiple myeloma , mobilization , transplantation , medicine , autologous stem cell transplantation , stem cell , retrospective cohort study , oncology , biology , political science , law , genetics
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 × 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 × 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. Am. J. Hematol., 2010. © 2009 Wiley‐Liss, Inc.