Abstract
Introduction
Induction treatment followed by autologous stem cell transplantation (ASCT) has been
accepted as the standard treatment for multiple myeloma (MM) patients. Granulocyte
colony stimulating agent (G-CSF), chemotherapy or agents likes plerixafor are being
used for the mobilization of stem cells from bone marrow. In this study, we evaluated
the impact of the mobilization methods on the outcome of MM patients after ASCT.
Method
The data of 205 MM patients who underwent ASCT at our center between December 2009
and January 2019 were retrospectively analyzed. Patients were divided into 2 groups
as good mobilizers (patients who were mobilized with G-CSF alone) and poor mobilizers
(patients who were failed to mobilize with G-CSF alone and mobilized with G-CSF + cylophosphomide
or G-CSF + plerixafor).
Results
The median progression free survival (PFS) was 18.27 ± 3.22 months in good mobilizers
and 14.22 ± 3.7 months in poor mobilizers. In G-CSF + cyclophosphamide method median
PFS was 15.4 ± 4.9 months wheras it was only 4 months in G-CSF + plerixafor method.
We did not find a statistically significant difference between good and poor mobilizers
regarding median PFS (p: 0.342). The median overall survival (OS) was found 34.48 ± 4.2
months in good mobilizers and 15.13 ± 5.78 months in poor mobilizers. In G-CSF + cyclophosphamide
method median OS was 17 ± 14.01 months wheras it was 10.66 ± 7.68 months in G-CSF + plerixafor
method. We found a statistically significant difference between good and poor mobilizers
regarding median OS (p: 0.007*).
Conclusion
Our study shows that difficulty in stem cell mobilization is correlated with worse
outcome.
Keywords
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Article info
Publication history
Published online: January 09, 2020
Accepted:
December 30,
2019
Received in revised form:
December 16,
2019
Received:
November 3,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.