Comparison of two autologous hematopoietic stem cell mobilization strategies in patients with multiple myeloma : CE plus G-CSF versus G-CSF only: A single-center retrospective analysis
© 2024 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB..
BACKGROUND: Despite recent advances in the treatment of multiple myeloma, high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) remains an essential therapeutic keystone. As for the stem cell mobilization procedure, different regimens have been established, usually consisting of a cycle of chemotherapy followed by application of granulocyte-colony stimulating factor (G-CSF), although febrile neutropenia is a common complication. Following national guidelines, our institution decided to primarily use G-CSF only mobilization during the COVID-19 pandemic to minimize the patients' risk of infection and to reduce the burden on the health system.
STUDY DESIGN AND METHODS: In this retrospective single-center analysis, the efficacy and safety of G-CSF only mobilization was evaluated and compared to a historic control cohort undergoing chemotherapy-based mobilization by cyclophosphamide and etoposide (CE) plus G-CSF.
RESULTS: Although G-CSF only was associated with a higher need for plerixafor administration (p < .0001) and a higher number of apheresis sessions per patient (p = .0002), we were able to collect the target dose of hematopoietic stem cells in the majority of our patients. CE mobilization achieved higher hematopoietic stem cell yields (p = .0015) and shorter apheresis sessions (p < .0001) yet was accompanied by an increased risk of febrile neutropenia (p < .0001). There was no difference in engraftment after ASCT.
DISCUSSION: G-CSF only mobilization is a useful option in selected patients with comorbidities and an increased risk of serious infections, especially in the wintertime or in future pandemics.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Transfusion - (2024) vom: 10. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dill, Veronika [VerfasserIn] |
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| Links: |
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| Themen: |
COVID‐19 |
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| Anmerkungen: |
Date Revised 11.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1111/trf.17829 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM370900006 |
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| 245 | 1 | 0 | |a Comparison of two autologous hematopoietic stem cell mobilization strategies in patients with multiple myeloma |b CE plus G-CSF versus G-CSF only: A single-center retrospective analysis |
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| 520 | |a © 2024 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB. | ||
| 520 | |a BACKGROUND: Despite recent advances in the treatment of multiple myeloma, high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) remains an essential therapeutic keystone. As for the stem cell mobilization procedure, different regimens have been established, usually consisting of a cycle of chemotherapy followed by application of granulocyte-colony stimulating factor (G-CSF), although febrile neutropenia is a common complication. Following national guidelines, our institution decided to primarily use G-CSF only mobilization during the COVID-19 pandemic to minimize the patients' risk of infection and to reduce the burden on the health system | ||
| 520 | |a STUDY DESIGN AND METHODS: In this retrospective single-center analysis, the efficacy and safety of G-CSF only mobilization was evaluated and compared to a historic control cohort undergoing chemotherapy-based mobilization by cyclophosphamide and etoposide (CE) plus G-CSF | ||
| 520 | |a RESULTS: Although G-CSF only was associated with a higher need for plerixafor administration (p < .0001) and a higher number of apheresis sessions per patient (p = .0002), we were able to collect the target dose of hematopoietic stem cells in the majority of our patients. CE mobilization achieved higher hematopoietic stem cell yields (p = .0015) and shorter apheresis sessions (p < .0001) yet was accompanied by an increased risk of febrile neutropenia (p < .0001). There was no difference in engraftment after ASCT | ||
| 520 | |a DISCUSSION: G-CSF only mobilization is a useful option in selected patients with comorbidities and an increased risk of serious infections, especially in the wintertime or in future pandemics | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID‐19 | |
| 650 | 4 | |a G‐CSF | |
| 650 | 4 | |a PBSC | |
| 650 | 4 | |a mobilization chemotherapy | |
| 650 | 4 | |a multiple myeloma | |
| 700 | 1 | |a Blüm, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Lindemann, Anja |e verfasserin |4 aut | |
| 700 | 1 | |a Biederstädt, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Högner, Marion |e verfasserin |4 aut | |
| 700 | 1 | |a Götze, Katharina S |e verfasserin |4 aut | |
| 700 | 1 | |a Bassermann, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Hildebrandt, Martin |e verfasserin |4 aut | |
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