Chemomobilization with Etoposide is Highly Effective in Patients with Multiple Myeloma and Overcomes the Effects of Age and Prior Therapy

Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
William A WoodT C Shea

Abstract

The optimal mobilization strategy prior to autologous stem cell transplantation for patients with multiple myeloma remains unclear. Mobilization with cytokines alone appears to yield suboptimal results in older patients as well as patients who have received prior lenalidomide. To avoid the marked cytopenias and risks of hemorrhagic cystitis associated with the administration of cyclophosphamide, we investigated the efficacy and safety of chemomobilization with an intermediate dose etoposide (VP-16; 375 mg/m(2) on days +1 and +2) and granulocyte-colony stimulating factor (G-CSF) (5 μg/kg twice daily from day +3 through the final day of collection). We reviewed our institutional experience with 152 myeloma patients mobilized with this regimen. The addition of VP-16 to G-CSF resulted in successful mobilization in 100% of patients, including 143 (94%) who collected successfully in a single day. A total of 99% of patients, including those with prior XRT and/or prior lenalidomide or thalidomide therapy, collected at least 5 × 10(6) cells/kg in 1 or 2 days of apheresis, and the median total number of CD34(+) cells collected in the entire population was 12 × 10(6) cells/kg. Collection was predictable, with 61% of patients collecting on...Continue Reading

References

Jun 11, 2008·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Tomer MarkRuben Niesvizky
Jan 14, 2009·Bone Marrow Transplantation·W BensingerJ M McCarty
May 20, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Uday PopatSergio Giralt

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Citations

Nov 21, 2012·Bone Marrow Transplantation·W A WoodT C Shea
Jan 3, 2014·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Hasan Atilla OzkanZafer Gulbas
Mar 24, 2016·Annals of the New York Academy of Sciences·Heather FairfieldMichaela R Reagan
Jun 28, 2015·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Musa Karakukcu, Ekrem Unal
May 13, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Hien K DuongPaul A Carpenter
Apr 8, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Eric ChowThomas C Shea
Jan 18, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Mehdi HamadaniFarrukh Awan
Nov 19, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Omotayo Fasan
Oct 22, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Sergio GiraltSteven Devine
Jul 6, 2014·Journal of Clinical Imaging Science·Christine U LeeSteven R Jacobson
Nov 7, 2017·World Journal of Transplantation·Whitney D Wallis, Muzaffar H Qazilbash

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