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• W2511360663 abstract "The ideal regimen for SCM in MM remains controversial. Chemomobilization with a single dose of cyclophosphamide (CY) with G-CSF (G) remains the most commonly used regimen. However, recent studies suggest that plerixafor (P) with G may be superior or equally effective as CY/G in first line SCM. We compared the efficacy and toxicities associated with CY/G versus P/G in MM pts who had SCM at our institution. From 1/2012 – 5/2015, 80 pts underwent SCM using CY/G or P/G. CY (3 gm/m2) was given day 1 (D1) with G starting D2. Pts were evaluated for the start of apheresis on D12. With P/G, pts started G on D1, P (0.24 mg/kg/day) on D4, and apheresis on D5. Demographics, CD34+ cell yield on D1 of apheresis, total CD34+ cell yield, toxicities, and time to engraftment were analyzed. Time to neutrophil recovery was based on the CIBMTR definition. Time to plt recovery was the first day with plt count ≥ 20 x 109 cells/L deemed not attributable to recent transfusions. Of the 80 pts, 35 had SCM with CY/G and 45 received P/G. All but 1 pt had ASCT with melphalan conditioning. The median CD34+ cell yield on D1 and median total yield were not significantly different between the 2 groups (Table 1). There was 1 poor mobilizer (< 2 x 106 cells/kg in ≤ 3 aphereses, PM) in the CY/G arm and none in the P/G arm. The number of good mobilizers (≥ 5 x 106 cells/kg in ≤ 2 days, GM) and rapid mobilizers (≥ 4 x 106 cells/kg on D1, RM) in both arms were comparable. Most pts in the CY/G (83%) and P/G (87%) arm completed SCM in 1 session. CY/G was associated with more severe neutropenia (86% vs 0%, P<0.001), hospitalization (11% vs 0%, P=0.020), and delay in apheresis (14% vs 0%, P=0.009). There were also more pts with febrile neutropenia (5% vs 0%) after CY/G. Mean time to neutrophil recovery was significantly shorter with CY/G than with P/G (10.8 vs 11.4, P=0.005), but plt recovery was not significantly different (13.6 vs 15.0, P=0.161). Our data indicate that CY/G and P/G result in robust SCM in most MM pts. Both regimens were comparable when evaluating efficacy and efficiency. However, P/G was better tolerated and had a more predictable course, specifically D1 of apheresis. Therefore, P/G may be considered as the preferred SCM regimen in MM.Table 1SCM and apheresis resultsCY/G (n=35)P/G (n=45)PD1 CD34+ cell yield, median10.968.650.170Total CD34+ cell yield, median10.968.700.052PM, N (%)1 (3)0 (0)0.254GM, N (%)32 (91)42 (93)0.748RM, N (%)32 (91)40 (89)*0.936Completed in 1 apheresis, N (%)29 (83)39 (87)0.636Completed in 2 aphereses, N (%)5 (14)4 (9)0.449*1 pt did not have D1 data Open table in a new tab Table 2EngraftmentCY/GP/GPMean time to ANC recovery (days)10.811.40.005Mean time to plt recovery (days)13.615.00.161 Open table in a new tab Table 3ToxicityCY/G (n=35)P/G (n=45)PDelay of planned apheresis D1, N (%)5 (14)0 (0)0.009Severe neutropenia, N (%)30 (86)0 (0)<0.001Neutropenic fever, N (%)2 (5)0 (0)0.104Hospitalization from SCM-related AEs, N (%)4 (11)0 (0)0.020 Open table in a new tab" @default.
• W2511360663 created "2016-09-16" @default.
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• W2511360663 date "2016-03-01" @default.
• W2511360663 modified "2023-09-27" @default.
• W2511360663 title "Comparing Cyclophosphamide with G-CSF and Plerixafor with G-CSF As Stem Cell Mobilization (SCM) Regimens for Multiple Myeloma (MM) Patients: An Evaluation of Mobilization Efficacy and Toxicity" @default.
• W2511360663 doi "https://doi.org/10.1016/j.bbmt.2015.11.470" @default.
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