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- Title
Stem cell mobilization performed with different doses of cytarabine in multiple myeloma patients relapsing after a previous autologous hematopoietic cell transplantation ― a multicenter report by the Polish Myeloma Study Group.
- Authors
Drozd-Sokołowska, Joanna; Waszczuk-Gajda, Anna; Maciejewska, Martyna; Topczewska, Magdalena; Dutka, Magdalena; Zaucha, Jan Maciej; Szmigielska-Kapłon, Anna; Nowicki, Mateusz; Olszewska-Szopa, Magdalena; Szeremet, Agnieszka; Czyż, Anna; Kozioł, Magdalena; Hus, Marek; Mańko, Joanna; Hus, Iwona; Romejko-Jarosińska, Joanna; Kopińska, Anna; Król, Małgorzata; Snarski, Emilian; Jamroziak, Krzysztof
- Abstract
Introduction: Salvage autologous hematopoietic cell transplantation (auto-HCT) constitutes a therapeutic option for multiple myeloma patients who experience relapse after a previous auto-HCT. When insufficient number of hematopoietic stem cells was stored from the initial harvest, remobilization of stem cells is necessary. The data on the efficacy and safety of different remobilization protocols are scarce, including the data on cytarabine dosing. Material i methods: A retrospective analysis of multiple myeloma patients who experienced relapse after a previous auto-HCT and afterwards underwent remobilization with cytarabine. Results: Sixty-five patients, 55% males, median age at remobilization 63 (37-71) years, were included. 80% patients did have a single, 20% a tandem auto-HCT before remobilization. The median time between the most recent auto-HCT and remobilization was 42 (8-239) months. The total cytarabine dose administered for remobilization was 2400 mg/m² in 29%, 2000 mg/m² in 2%, 1600 mg/m² in 58%, and 800 mg/m² in 11% patients. Plerixafor rescue was used in 23% patients (29% from the group 1600 mg/m², 20% ― 2000-2400 mg/m²). Successful remobilization (>2 × 106 CD34+ cells//kg) was possible in 82% patients; 80% in a group 2000-2400 mg/m², 87% 1600 mg/m², and 57% 800 mg/m². The total yield of CD34+ cells (× 106/kg) after the first remobilization for patients for whom any collection was possible was: 8.22 (0.65-18.49) for cytarabine 2400 mg/m², 4.87 (0.98-33.6%) 1600 mg/m², and 5.36 (1.52-9.07) 800 mg/m². Toxicity was mostly hematological. Remobilization was associated with one death due to septic shock. Conclusion: Remobilization with cytarabine after previous auto-HCT was feasible only in a proportion of patients. Cytarabine dose of 800 mg/m² was associated with the lowest rate of successful remobilization, the group was however small and not rescued with plerixafor. Future research is needed to elucidate whether the 800 mg/m² is similarly efficient to higher doses.
- Subjects
HEMATOPOIETIC stem cell transplantation; MULTIPLE myeloma; STEM cells; CYTARABINE; DISEASE relapse
- Publication
Acta Haematologica Polonica, 2022, Vol 53, Issue A, p80
- ISSN
0001-5814
- Publication type
Article