The effect of gradual increment in rhG-CSF dose on stem cell yields in patients with multiple myeloma mobilized with intermediate dose cyclophosphamide plus rhG-CSF

Transfus Apher Sci. 2014 Feb;50(1):71-4. doi: 10.1016/j.transci.2013.11.003. Epub 2013 Dec 4.

Abstract

Cyclophosphamide along with recombinant human granulocyte-colony stimulating factor (rhG-CSF) is a commonly used strategy for mobilization. However, the optimal timing for rhG-CSF initiation after cyclophosphamide has not been determined as conclusively as has the G-CSF dose. In this paper, we aimed to present gradual dose increment of rhG-CSF between the third day of mobilization and time to apheresis that is started with 5 μg/kg (from day 3 to day 7) and continued with 10 μg/kg (from day 8 to time to apheresis) for peripheral blood stem cell (PBSC) mobilization in multiple myeloma (MM) patients and its effect on stem cell yield and mobilization success. Data from 30 consecutive patients with MM who underwent PBSC mobilization between October 2011 and June 2013, were retrospectively reviewed. While twenty-eight of 30 patients (93.3%) were successfully mobilized, 2 patients (6.7%) had mobilization failure. The final median CD34+ cell dose harvested from the patients was 9.5×10(6)/kg. The median number of apheresis was 2.5 (range, 0-3). Twenty-four patients (80%) yielded >2×10(6) CD34+ cells/kg in one apheresis procedure. In conclusion, our regimen might be used to decrease the mobilization failure regarding the low dose rhG-CSF use and provide a cost effective strategy.

Keywords: Cyclophosphamide; Granulocyte colony stimulating factor; Multiple myeloma; Stem cell mobilization.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD34 / metabolism
  • Blood Component Removal
  • Cost-Benefit Analysis
  • Cyclophosphamide / therapeutic use*
  • Female
  • Granulocyte Colony-Stimulating Factor / economics
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hematopoietic Stem Cell Mobilization / economics
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / therapy
  • Recombinant Proteins / therapeutic use
  • Retrospective Studies
  • Time Factors

Substances

  • Antigens, CD34
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Cyclophosphamide