Premium
Modified CVAD and modified CBAD compared to high‐dose cyclophosphamide for peripheral blood stem cell mobilization in patients with multiple myeloma
Author(s) -
Gettys Suzanne C.,
Gulbis Alison,
Wilhelm Kaci,
Sasaki Koji,
Dinh Yvonne,
Rondon Gabriela,
Qazilbash Muzaffar H.
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12843
Subject(s) - medicine , multiple myeloma , cyclophosphamide , plerixafor , dexamethasone , bortezomib , hematopoietic stem cell transplantation , oncology , gastroenterology , surgery , urology , chemotherapy , transplantation , cxcr4 , chemokine , receptor
Background The optimal regimen for peripheral blood stem cell ( PBSC ) mobilization in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation (auto‐ HCT ) has not been established. Experience at The University of Texas MD Anderson Cancer Center suggests in addition to single‐agent cyclophosphamide (Cy), modified cyclophosphamide, vincristine, doxorubicin, and dexamethasone ( mCVAD ), and modified cyclophosphamide, bortezomib, doxorubicin, and dexamethasone ( mCBAD ) may be successful chemomobilization regimens. Methods This retrospective review included 167 patients (66 with Cy, 74 with mCVAD , and 27 with mCBAD ) with multiple myeloma undergoing mobilization for auto‐ HCT between January 1, 2006 and September 30, 2013. The primary objective was to evaluate and compare the successful mobilization of CD 34+ cells among high‐dose Cy, mCVAD or mCBAD . Results Successful mobilization (≥2×10 6 CD 34+ cells/kg) was achieved in all patients, while 65 (98%), 72 (97%), and 27 (100%) patients achieved an optimal mobilization (≥4×10 6 CD 34+ cells/kg) in the Cy, mCVAD , and mCBAD groups, respectively. There was no significant difference in the number of apheresis sessions ( P =.63), incidence of febrile neutropenia ( P =.57), or hospital admission rates ( P =.55). Conclusion Either Cy, mCVAD , or mCBAD can yield successful PBSC mobilization in patients with multiple myeloma undergoing auto‐HCT.