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Improved progression-free and event-free survival in myeloma patients undergoing PBSCH receiving a cyclophosphamide + G-CSF regimen than G-CSF alone

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Abstract

Two regimens are commonly used for peripheral blood hematopoietic stem cell harvesting (PBSCH) in multiple myeloma: high-dose cyclophosphamide (HD-CY) + granulocyte-colony stimulating factor (G-CSF), and G-CSF alone. The objective of the present study was to evaluate the anti-myeloma effect of the PBSCH regimen including HD-CY. We retrospectively assessed harvesting efficiency, complications, and anti-myeloma effects in 115 patients receiving HD-CY + G-CSF (HD-CY group) and 32 patients receiving G-CSF alone (G-alone group). We collected > 2 × 106 CD34-positive cells/kg from 93 and 75% of patients in the HD-CY and G-alone groups, respectively (P = 0.0079). The mean HSC count was also higher in the HD-CY group. No severe complications were observed in the G-alone group, whereas 66% of patients in the HD-CY group were treated with intravenous antibiotics. The median progression-free and event-free survival (PFS and EFS) were longer in the HD-CY group than in the G-alone group (28 vs. 18 months and 25 vs. 13 months, respectively; P = 0.0127 and 0.0139), with no difference in median overall survival. HD-CY showed anti-myeloma effect, as verified by prolonged EFS and PFS, when a vincristine, doxorubicin, and dexamethasone regimen was administered as induction before PBSCH.

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Authors and Affiliations

  1. Department of Hematology, Tokyo-Kita Medical Center, 4-17-56 Akabanedai, Kita-ku, Tokyo, Japan

    Akira Tanimura, Risen Hirai, Masataka Takeshita & Akiyoshi Miwa

  2. Division of Hematology, National Center for Global Health and Medicine, Tokyo, Japan

    Miki Nakamura

  3. Division of Hematology, Tokyo Women’s Medical University, Tokyo, Japan

    Shotaro Hagiwara

Authors
  1. Akira Tanimura
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  2. Risen Hirai
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Correspondence to Akira Tanimura.

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Tanimura, A., Hirai, R., Nakamura, M. et al. Improved progression-free and event-free survival in myeloma patients undergoing PBSCH receiving a cyclophosphamide + G-CSF regimen than G-CSF alone. Int J Hematol 107, 559–567 (2018). https://doi.org/10.1007/s12185-018-2408-4

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  • DOI: https://doi.org/10.1007/s12185-018-2408-4

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