DCEP chemotherapy followed by a single, fixed dose of pegylated filgrastim allows adequate stem cell mobilization in multiple myeloma patients

Transfusion. 2008 May;48(5):857-60. doi: 10.1111/j.1537-2995.2007.01621.x. Epub 2008 Feb 1.

Abstract

Background: Pegylated filgrastim (PEG-f), a long-lasting granulocyte-colony-stimulating factor, has been used in different hematologic conditions to shorten chemotherapy-induced neutropenia and to mobilize peripheral blood stem cells. Data on mobilization efficacy in patients with multiple myeloma are, however, still limited.

Study design and methods: The feasibility and mobilizing capacity of DCEP chemotherapy followed by a single subcutaneous dose of 6 mg of PEG-f in 23 myeloma patients (11 females and 12 males) whose median age was 55 years (range, 31-67 years) were investigated.

Results: The median number of CD34+ cells collected was 5.72 x 10(6) per kg body weight with a range between 0 x 10(6) and 29.4 x 10(6) per kg body weight. Twenty patients (87%) yielded more than 2 x 10(6) per kg body weight CD34+ cells. Among the 22 patients who mobilized some CD34+ cells, 27 leukapheresis procedures were carried out (a single leukapheresis procedure in 17 patients and 2 leukapheresis procedures in 5). The median interval between the start of chemotherapy and the first leukapheresis procedure was 12 days (range, 11-16 days). With regard to tolerability, 7 patients complained of mild to moderate back pain, controlled with oral analgesics. No patient was hospitalized, and no fever or infections occurred.

Conclusion: These results, compared with those previously reported for the DCEP-filgrastim combination, suggest that DCEP chemotherapy followed by PEG-f is a promising combination to mobilize peripheral blood stem cells in myeloma patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antigens, CD34 / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Injections, Subcutaneous
  • Leukapheresis
  • Male
  • Middle Aged
  • Multiple Myeloma / blood*
  • Multiple Myeloma / drug therapy*
  • Neutropenia / drug therapy
  • Neutropenia / prevention & control
  • Polyethylene Glycols / administration & dosage*
  • Recombinant Proteins
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Recombinant Proteins
  • pegylated granulocyte colony-stimulating factor, human
  • Granulocyte Colony-Stimulating Factor
  • Polyethylene Glycols
  • Etoposide
  • Dexamethasone
  • Cyclophosphamide
  • Filgrastim
  • Cisplatin

Supplementary concepts

  • DCEP protocol