A randomized phase II study of stem cell mobilization with cyclophosphamide+G-CSF or G-CSF alone after lenalidomide-based induction in multiple myeloma

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作者
R Silvennoinen
P Anttila
M Säily
T Lundan
J Heiskanen
T M Siitonen
S Kakko
M Putkonen
H Ollikainen
V Terävä
A Kutila
K Launonen
A Räsänen
A Sikiö
M Suominen
P Bazia
K Kananen
T Selander
T Kuittinen
K Remes
E Jantunen
机构
[1] Kuopio University Hospital,Department of Medicine
[2] Cancer Center,Department of Clinical Chemistry and TYKSLAB
[3] Helsinki University Central Hospital,Department of Medicine
[4] Hematology-Oncology Unit,Department of Medicine
[5] Oulu University Hospital,Department of Medicine
[6] University of Turku and Turku University Central Hospital,Department of Medicine
[7] Hematology Unit,Department of Medicine
[8] Turku University Central Hospital,Department of Medicine
[9] Satakunta Central Hospital,Department of Medicine
[10] Hematology Unit,Department of Clinical Hematology
[11] Tampere University Hospital,undefined
[12] Mikkeli Central Hospital,undefined
[13] Länsi-Pohja Central Hospital,undefined
[14] Kymenlaakso Central Hospital,undefined
[15] Central Finland Central Hospital,undefined
[16] Kanta-Häme Central Hospital,undefined
[17] Kainuu Central Hospital,undefined
[18] Science Services Center,undefined
[19] Kuopio University Hospital,undefined
[20] University of Turku,undefined
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摘要
The most common means of mobilizing autologous stem cells is G-CSF alone or combined with cyclophosphamide (CY) to obtain sufficient CD34+ cells for one to two transplants. There are few prospective, randomized studies investigating mobilization regimens in multiple myeloma (MM), especially after lenalidomide-based induction. We designed this prospective, randomized study to compare low-dose CY 2 g/m2+G-CSF (arm A) and G-CSF alone (arm B) after lenalidomide-based up-front induction in MM. Of the 80 initially randomized patients, 69 patients were evaluable, 34 and 35 patients in arms A and B, respectively. The primary end point was the proportion of patients achieving a yield of ⩾3 × 106/kg CD34+ cells with 1−2 aphereses, which was achieved in 94% and 77% in arms A and B, respectively (P=0.084). The median number of aphereses needed to reach the yield of ⩾3 × 106/kg was lower in arm A than in arm B (1 vs 2, P=0.035). Two patients needed plerixafor in arm A and five patients in arm B (P=0.428). Although CY-based mobilization was more effective, G-CSF alone was successful in a great majority of patients to reach the defined collection target after three cycles of lenalidomide-based induction.
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页码:372 / 376
页数:4
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