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Hematopoietic progenitor cell mobilization using low‐dose cyclophosphamide and granulocyte colony‐stimulating factor for multiple myeloma
Author(s) -
Shimura Yuji,
Kuroda Junya,
Uchiyama Hitoji,
KawataIida Eri,
Tsutsumi Yasuhiko,
Nagoshi Hisao,
Mizutani Shinsuke,
YamamotoSugitani Mio,
Matsumoto Yosuke,
Kobayashi Tsutomu,
Horiike Shigeo,
Shimazaki Chihiro,
Kaneko Hiroto,
Kobayashi Yutaka,
Taniwaki Masafumi
Publication year - 2013
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21283
Subject(s) - medicine , granulocyte colony stimulating factor , regimen , cyclophosphamide , neutropenia , filgrastim , multiple myeloma , cohort , apheresis , febrile neutropenia , gastroenterology , oncology , leukopenia , hematopoietic stem cell transplantation , cd34 , transplantation , surgery , chemotherapy , stem cell , platelet , biology , genetics
High‐dose chemotherapy (HDT) supported by autologous stem cell transplantation (ASCT) has long been one of the standards of care for younger patients with multiple myeloma (MM). Cyclophosphamide (CY) plus granulocyte colony‐stimulating factor (G‐CSF) has been the conventional preparation for hematopoietic progenitor cell (HPC) mobilization, although the optimal dosage of CY in this setting has not yet been clearly defined. This study investigated the efficacy and safety of low‐dose (LD‐)CY (1.5 g/m 2 ) plus G‐CSF for conditioning for HPC apheresis harvest (HPC‐A) in 18 MM patients, and compared it with a regimen consisting of intermediate‐dose (ID)‐CY (4 g/m 2 ) plus G‐CSF for 13 MM patients. Eleven patients in the former and six in the latter were treated with bortezomib (BTZ) during the induction therapy. Both regimens were comparably effective in terms of CD34 + cell yields, while adverse events, such as leukopenia, thrombocytopenia, and febrile neutropenia, occurred significantly less frequently in the LD‐CY cohort. All patients in LD‐CY cohort started and completed their apheresis on day 7 or 8, whereas for the ID‐CY cohort the day of first apheresis varied widely from day 8 to 15. These findings indicate that the LD‐CY regimen is as effective as ID‐CY for HPC mobilization, while the former is clearly more practicable and convenient than the ID‐CY regimen for patients with MM. J. Clin. Apheresis 28:368–373, 2013. © 2013 Wiley Periodicals, Inc.