Effective Salvage Mobilization of Peripheral Blood Stem Cells with High-Dose Etoposide in Newly Diagnosed Multiple Myeloma Patients Who Failed Initial Mobilization with High-Dose Cyclophosphamide.
10.19746/j.cnki.issn.1009-2137.2025.05.021
- Author:
Yue-Qi WANG
1
;
Shi-Hua ZHAO
1
;
Yi MA
1
;
Xi-Lin CHEN
1
;
Shun-Zong YUAN
1
;
Na-Na CHENG
1
;
Guang-Ning SHI
1
;
Wen-Rong HUANG
1
;
Xiu-Bin XIAO
1
Author Information
1. Department of Lymphoma Plasma Cell Diseases, Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China.
- Publication Type:Journal Article
- Keywords:
multiple myeloma;
peripheral blood stem cells;
mobilization;
etoposide;
cyclophosphamide
- MeSH:
Humans;
Multiple Myeloma/therapy*;
Etoposide/therapeutic use*;
Hematopoietic Stem Cell Mobilization/methods*;
Cyclophosphamide/therapeutic use*;
Granulocyte Colony-Stimulating Factor;
Salvage Therapy;
Peripheral Blood Stem Cells;
Male;
Middle Aged;
Female;
Peripheral Blood Stem Cell Transplantation
- From:
Journal of Experimental Hematology
2025;33(5):1380-1385
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the safety and efficacy of high-dose etoposide (VP-16) combined with recombinant human granulocyte colony-stimulating factor (rhG-CSF) as salvage mobilization for peripheral blood stem cells (PBSC) in newly diagnosed multiple myeloma (NDMM) patients.
METHODS:From April 2021 to May 2023, eight NDMM patients who had failed to yield sufficient PBSC during initial mobilization with high-dose cyclophosphamide (CTX) combined with rhG-CSF underwent salvage mobilization with 1.2 g/m2 etoposide combined with rhG-CSF 10 μg/(kg·d). The effects and adverse reactions of initial mobilization and salvage mobilization were analyzed.
RESULTS:For salvage mobilization and initial mobilization, the numbers of PBSC collections were 16 and 18, respectively. The mean value of total collected CD34+ cells were (11.90±5.75)×106/kg and (1.67±0.75)×106/kg (P =0.0010) in salvage mobilization group and initial mobilization group, respectively. The proportion of patients with a total collection of CD34+ cell count≥2×106/kg were 100% and 37.5% (P =0.0625), and the proportion of patients with a total collection of CD34+ cell count≥5×106/kg were 87.5% and 0% (P =0.0156) in salvage mobilization group and initial mobilization group, respectively. For five patients who underwent high-dose CTX initial mobilization but had a total CD34+ cell count < 2×106/kg, successful collection was achieved through salvage mobilization with high-dose VP-16. Salvage mobilization with high-dose VP-16 was scheduled 2-3 weeks after failure of CTX mobilization. Adverse reactions of high-dose VP-16 mobilization did not increase compared to the initial mobilization with high-dose CTX.
CONCLUSION:As a salvage mobilization regimen, VP-16 1.2 g/m2 combined with rhG-CSF is safe and highly effective in NDMM patients who failed to initial mobilization with high-dose CTX combined with rhG-CSF.
