Cyclophosphamide-based stem cell mobilization in relapsed multiple myeloma patients: A subgroup analysis from the phase III trial ReLApsE

  • Marc-Andrea Baertsch
  • Jana Schlenzka
  • Katharina Lisenko
  • Julia Krzykalla
  • Natalia Becker
  • Katja Weisel
  • Richard Noppeney
  • Hans Martin
  • Hans W Lindemann
  • Mathias Haenel
  • Axel Nogai
  • Christof Scheid
  • Hans Salwender
  • Roland Fenk
  • Ullrich Graeven
  • Peter Reimer
  • Martin Schmidt-Hieber
  • Martin Goerner
  • Ingo G H Schmidt-Wolf
  • Stefan Klein
  • Anthony D Ho
  • Hartmut Goldschmidt
  • Patrick Wuchter

Abstract

OBJECTIVE: Analysis of the efficiency and toxicity of cyclophosphamide-based stem cell mobilization in patients with relapsed multiple myeloma (RMM).

METHODS: Peripheral blood stem cells (PBSCs) were mobilized with high dose cyclophosphamide (2 g/m2 daily on days 1 and 2) and G-CSF plus pre-emptive/rescue plerixafor in RMM patients (first to third relapse) treated within the ReLApsE trial of the German-Speaking Myeloma Multicenter Group (GMMG).

RESULTS: Mobilization was initiated with high-dose cyclophosphamide (HD-CY) and G-CSF in 30 patients. Fifteen patients received additional pre-emptive/rescue administration of plerixafor. Stem cell collection was successful (≥2×106 CD34+ cells per kg bw) in 77% (23/30 patients). Patients with prior high-dose melphalan collected a significantly lower median total number of PBSCs than patients without prior high-dose melphalan (3.3×106 vs 17×106 CD34+ cells/kg bw). Toxicity of HD-CY was frequent with 12 serious adverse events (SAE) in 37% of patients (11/30 patients). Infections accounted for the majority of SAE reports. In two patients, SAEs were lethal (septic shock).

CONCLUSIONS: These data proof feasibility of PBSC collection at relapse but emphasize the importance of collection and storage of additional PBSC transplants during first-line treatment when mobilization is more efficient and less toxic.

Bibliografische Daten

OriginalspracheEnglisch
ISSN0902-4441
DOIs
StatusVeröffentlicht - 07.2017
Extern publiziertJa
PubMed 28370401