Factors influencing collection of peripheral blood progenitor cells following high-dose cyclophosphamide and granulocyte colony-stimulating factor in patients with multiple myeloma

• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Verfasst von: Hegenbart, Ute [VerfasserIn]
• Verfasst von: Wallmeier, M. [VerfasserIn]
• Verfasst von: Hohaus, Stefan [VerfasserIn]
• Verfasst von: Haas, Rainer [VerfasserIn]
• Titel: Factors influencing collection of peripheral blood progenitor cells following high-dose cyclophosphamide and granulocyte colony-stimulating factor in patients with multiple myeloma
• Verf.angabe: H. Goldschmidt, U. Hegenbart, M. Wallmeier, S. Hohaus and R. Haas
• E-Jahr: 1997
• Jahr: September 1997
• Umfang: 20 S.
• Fussnoten: Elektronische Reproduktion der Druck-Ausgabe 29. Oktober 2003 ; Gesehen am 24.04.2025
• Titel Quelle: Enthalten in: British journal of haematology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1955
• Jahr Quelle: 1997
• Band/Heft Quelle: 98(1997), 3, Seite 736-755
• ISSN Quelle: 1365-2141
• DOI: doi:10.1046/j.1365-2141.1997.2783095.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: G-CSF
• Sach-SW: high-dose cyclophosphamide
• Sach-SW: multiple myeloma
• Sach-SW: peripheral blood progenitor cell mobilization
• Sach-SW: transplantation
• K10plus-PPN: 1923583824

Abstract

We treated 103 multiple myeloma (MM) patients with 7 g/m2 cyclophosphamide (Cy) followed by 300 μg G-CSF/d to harvest peripheral blood progenitor cells (PBPC). PBPC autografts containing > 2.0 × 106 CD34+ cells per kg body weight were obtained at the first attempt from 90/100 evaluable patients. The most significant factor predicting impairment of PBPC collection was the duration of previous melphalan treatment (P < 0.0001). In multivariate discriminate analysis, treatment with melphalan during the most recent chemotherapy cycles prior to mobilization (P = 0.0727) and previous radiotherapy (P = 0.0628) had a marginally significant negative influence on the efficacy of PBPC collection. We found no reduced functional capacity of CD34+ cells to restore haemopoiesis after myeloablative treatment related to the duration of melphalan exposure. At the time of best response to conventional treatment, a median paraprotein reduction of 21% was achieved following high-dose cyclophosphamide (HD-Cy). Two heavily pretreated patients died and one patient developed pulmonary toxicity W.H.O. grade IV following HD-Cy. Potential transplant candidates should undergo mobilization and harvesting of PBPC before melphalan-containing treatment. Combinations of haemopoietic growth factors and their dose modifications should be investigated to improve PBPC collection, to allow a dosage reduction of the mobilization chemotherapy.