Efficient mobilization of peripheral blood stem cells following CAD chemotherapy and a single dose of pegylated G-CSF in patients with multiple myeloma

High-dose chemotherapy followed by autologous blood stem cell transplantation is the standard treatment for myeloma patients. In this study, CAD (cyclophosphamide, adriamycin, dexamethasone) chemotherapy and a single dose of pegfilgrastim (12 mg) was highly effective in mobilizing peripheral blood s...

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Main Authors: Frühauf, Stefan (Author) , Klaus, Johanna (Author) , Hüsing, Johannes (Author) , Veldwijk, Marlon Romano (Author) , Buß, Eike Christian (Author) , Topaly, Julian (Author) , Seeger, Timon (Author) , Zeller, L. (Author) , Möhler, Thomas (Author) , Ho, Anthony Dick (Author) , Goldschmidt, Hartmut (Author)
Format: Article (Journal)
Language:English
Published: 23 April 2007
In: Bone marrow transplantation
Year: 2007, Volume: 39, Issue: 12, Pages: 743-750
ISSN:1476-5365
DOI:10.1038/sj.bmt.1705675
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/sj.bmt.1705675
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/1705675
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Author Notes:S. Fruehauf, J. Klaus, J. Huesing, M.R. Veldwijk, E.C. Buss, J. Topaly, T. Seeger, L.W.J. Zeller, T. Moehler, A.D. Ho and H. Goldschmidt

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520 |a High-dose chemotherapy followed by autologous blood stem cell transplantation is the standard treatment for myeloma patients. In this study, CAD (cyclophosphamide, adriamycin, dexamethasone) chemotherapy and a single dose of pegfilgrastim (12 mg) was highly effective in mobilizing peripheral blood stem cells (PBSCs) for subsequent transplantation, with 88% of patients (n = 26) achieving the CD34+ cell harvest target of > or = 7.50 x 10(6) CD34+ cells/kg body weight, following a median of two apheresis procedures (range 1-4) and with first apheresis performed at a median day 13 after CAD application (range 10-20). Patients treated with pegfilgrastim showed a reduced time to first apheresis procedure from mobilization compared with filgrastim-mobilized historical matched controls (n = 52, P = 0.015). The pegfilgrastim mobilization regimen allowed for transplantation of a median of 3.58 x 10(6) CD34+ cells/kg body weight while leaving sufficient stored cells for a second high-dose regimen and back-ups in most patients. Engraftment following transplantation was comparable to filgrastim, with a median time of 14 days to leucocyte > or =1.0 x 10(9)/l (range 10-21) and 11 days to platelets > or = 20 x 10(9)/l (range 0-15). The results of this study thus provide further support for the clinical utility of pegfilgrastim for the mobilization of PBSC following chemotherapy in cancer patients scheduled for transplantation. 
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