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Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation.

  • Author(s): 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
  • et al.
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.

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