학술논문
Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation
Document Type
article
Author
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; D'Souza, A
Source
Bone Marrow Transplantation. 50(12)
Subject
Language
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.