Hematopoietic progenitor cell mobilization using low-dose cyclophosphamide and granulocyte colony-stimulating factor for multiple myeloma

Authors

  • Yuji Shimura,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Junya Kuroda,

    Corresponding author
    • Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Hitoji Uchiyama,

    1. Division of Hematology, Department of Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan
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  • Eri Kawata-Iida,

    1. Division of Hematology, Department of Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan
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  • Yasuhiko Tsutsumi,

    1. Division of Hematology, Department of Medicine, Kyoto First Red Cross Hospital, Kamigyo-ku, Kyoto, Japan
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  • Hisao Nagoshi,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Shinsuke Mizutani,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Mio Yamamoto-Sugitani,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Yosuke Matsumoto,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Tsutomu Kobayashi,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
    2. Division of Hematology, Department of Medicine, Kyoto First Red Cross Hospital, Kamigyo-ku, Kyoto, Japan
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  • Shigeo Horiike,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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  • Chihiro Shimazaki,

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
    2. Division of Hematology, Department of Medicine, Kyoto Social Insurance Hospital, Kyoto, Japan
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  • Hiroto Kaneko,

    1. Division of Hematology, Department of Medicine, Kyoto First Red Cross Hospital, Kamigyo-ku, Kyoto, Japan
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  • Yutaka Kobayashi,

    1. Division of Hematology, Department of Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan
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  • Masafumi Taniwaki

    1. Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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Correspondence to: J. Kuroda, Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602–8566, Japan. E-mail: junkuro@koto.kpu-m.ac.jp

Abstract

High-dose chemotherapy (HDT) supported by autologous stem cell transplantation (ASCT) has long been one of the standards of care for younger patients with multiple myeloma (MM). Cyclophosphamide (CY) plus granulocyte colony-stimulating factor (G-CSF) has been the conventional preparation for hematopoietic progenitor cell (HPC) mobilization, although the optimal dosage of CY in this setting has not yet been clearly defined. This study investigated the efficacy and safety of low-dose (LD-)CY (1.5 g/m2) plus G-CSF for conditioning for HPC apheresis harvest (HPC-A) in 18 MM patients, and compared it with a regimen consisting of intermediate-dose (ID)-CY (4 g/m2) plus G-CSF for 13 MM patients. Eleven patients in the former and six in the latter were treated with bortezomib (BTZ) during the induction therapy. Both regimens were comparably effective in terms of CD34+ cell yields, while adverse events, such as leukopenia, thrombocytopenia, and febrile neutropenia, occurred significantly less frequently in the LD-CY cohort. All patients in LD-CY cohort started and completed their apheresis on day 7 or 8, whereas for the ID-CY cohort the day of first apheresis varied widely from day 8 to 15. These findings indicate that the LD-CY regimen is as effective as ID-CY for HPC mobilization, while the former is clearly more practicable and convenient than the ID-CY regimen for patients with MM. J. Clin. Apheresis 28:368–373, 2013. © 2013 Wiley Periodicals, Inc.

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