1. Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation
- Author
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Uy, GL, Costa, LJ, Hari, PN, Zhang, M-J, Huang, J-X, Anderson, KC, Bredeson, CN, Callander, NS, Cornell, RF, Perez, MAD, Dispenzieri, A, Freytes, CO, Gale, RP, Garfall, A, Gertz, MA, Gibson, J, Hamadani, M, Lazarus, HM, Kalaycio, ME, Kamble, RT, Kharfan-Dabaja, MA, Krishnan, AY, Kumar, SK, Kyle, RA, Landau, HJ, Lee, CH, Maiolino, A, Marks, DI, Mark, TM, Munker, R, Nishihori, T, Olsson, RF, Ramanathan, M, Rodriguez, TE, Saad, AA, Savani, BN, Schiller, GJ, Schouten, HC, Schriber, JR, Scott, E, Seo, S, Sharma, M, Ganguly, S, Stadtmauer, EA, Tay, J, To, LB, Vesole, DH, Vogl, DT, Wagner, JL, Wirk, B, Wood, WA, and D'Souza, A
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Rare Diseases ,Stem Cell Research - Nonembryonic - Human ,Cancer ,Hematology ,Clinical Research ,Stem Cell Research ,Transplantation ,Regenerative Medicine ,Adolescent ,Adult ,Aged ,Autografts ,Disease-Free Survival ,Female ,Hematopoietic Stem Cell Mobilization ,Hematopoietic Stem Cell Transplantation ,Humans ,Leukocyte Count ,Male ,Middle Aged ,Multiple Myeloma ,Platelet Count ,Prospective Studies ,Recovery of Function ,Survival Rate ,Clinical Sciences ,Oncology and Carcinogenesis ,Immunology ,Cardiovascular medicine and haematology ,Oncology and carcinogenesis - Abstract
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.
- Published
- 2015