%0 Journal Article
%T Cytarabine£¿+£¿G-CSF is more effective than cyclophosphamide£¿+£¿G-CSF as a stem cell mobilization regimen in multiple myeloma
%J -
%D 2018
%R https://doi.org/10.1038/s41409-018-0396-x
%X Cyclophosphamide (Cy) plus granulocyte-colony stimulating factor (G-CSF) is currently a standard regimen for hematopoietic stem cell (HSC) mobilization in patients with multiple myeloma (MM). However, cytarabine (AraC) in intermediate doses plus G-CSF seems to have a higher mobilization efficacy. The aim of this study was to retrospectively compare mobilization using AraC and Cy. Thirty consecutive MM patients were mobilized by Cy£¿+£¿G-CSF, and the subsequent 40 patients by AraC£¿+£¿G-CSF. Both groups were comparable. The target yield of 10£¿¡Á£¿106 CD34+£¿cells/kg (for tandem and 2 additional transplantations) was achieved in 98% (AraC) and 57% (Cy) of patients (p£¿<£¿0.0001) by 1.2 and 2.1 apheresis (means), and by single apheresis in 83 and 17% of patients, respectively. AraC mobilization resulted in higher peak concentration of CD34+£¿cells in blood (median 238.0 vs. 87.9/¦ÌL, p£¿<£¿0.0001) and higher CD34+£¿yield (median 28.6£¿¡Á£¿106 vs. 10.4£¿¡Á£¿106/kg, p£¿<£¿0.0001) compared to Cy mobilization. Toxicities were comparable except for thrombocytopenia gr. 4, observed in 50% of patients after AraC (Cy 7%). In view of these results, we conclude that mobilization with AraC plus G-CSF is very effective with acceptable toxicity and could be considered in MM patients with planned or expected higher numbers of transplantations
%U https://www.nature.com/articles/s41409-018-0396-x