Abstract
High-dose chemotherapy followed by autologous stem cell transplantation is a major
component in the treatment of patients with multiple myeloma. As a prerequisite, the
successful collection of a sufficient number of viable peripheral blood hematopoietic
CD34+ cells is critical. A common standard protocol for mobilization is currently
not defined and critically discussed especially in German-speaking Europe. In times
of the Covid-19 pandemic, safe and effective strategies have to be chosen to minimize
hospitalization times and severe courses.
In this single-center retrospective analysis, safety and efficacy of cyclophosphamide
plus etoposide (CE) and growth-factor support (n = 33) was compared to cyclophosphamide
mono treatment and growth-factor support (n = 49) in 82 patients with multiple myeloma
at first diagnosis.
CE was superior to cyclophosphamide mono with a significantly higher number of collected
CD34+ cells (15.46 × 106 CD34+ cells/kg vs. 9.92 × 106 CD34+ cells/kg), significantly faster engraftment of granulocytes after stem cell transplantation
(day 10.5 vs. day 11.6), shorter duration of the inpatient stay (17.47 days vs. 19.16
days) and significantly less transfusions (8.82 % vs. 30.61 % patients receiving transfusions).
The safety profile was comparable in both groups and in line with published data.
We conclude that CE is a safe and highly effective mobilization protocol in patients
with multiple myeloma at first diagnosis and appears to be superior to the commonly
used cyclophosphamide mono regimen.
Keywords
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Article info
Publication history
Published online: June 18, 2021
Accepted:
June 17,
2021
Received in revised form:
June 15,
2021
Received:
March 21,
2021
Identification
Copyright
© 2021 Published by Elsevier Ltd.
