TY - JOUR
T1 - Plerixafor on-demand in association with low-dose cyclophosphamide and G-CSF in the mobilization of patients with multiple myeloma
T2 - High effectiveness, low toxicity, and affordable cost
AU - for GITMO
AU - Milone, Giuseppe
AU - Conticello, Concetta
AU - Leotta, Salvatore
AU - Michieli, Maria Grazia
AU - Martino, Massimo
AU - Marco, Anna Lia Di
AU - Spadaro, Andrea
AU - Cupri, Alessandra
AU - Condorelli, Annalisa
AU - Milone, Giulio Antonio
AU - Markovic, Uros
AU - Sciortino, Roberta
AU - Schininà, Giovanni
AU - Moschetti, Gaetano
AU - Villari, Loredana
AU - Saccardi, Riccardo
N1 - Funding Information:
Giuseppe Milone and Riccardo Saccardi received speaker or consultancy fees from Sanofi. As also reported in the manuscript text, Giuseppe Milone received funding from the Company Sanofi to support some activities needed to complete this study.
Publisher Copyright:
© 2020
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/1
Y1 - 2020/1
N2 - In CD34+ cells mobilization of patients with multiple myeloma (MM), the use of Cyclophosphamide (CTX) at a dose of 2 g/m2 has low efficacy although also lower toxicity. The suboptimal mobilizing effect of low-dose CTX, however, may be overcome by plerixafor (PLX) on demand. We conducted a prospective multicenter study in 138 patients with MM to evaluate CTX 2 g/m2 in association with granulocyte-colony stimulating factor (G-CSF) and on-demand PLX. We compared results with a historical group of MM patients (n = 138) mobilized using CTX at a dose of 4 g/m2. CD34+ cells greater than 2 × 106/kg in max three aphereses were harvested in 98.6% of patients in the on-demand PLX study group while in 84.0% in the historical group, (p = 0.0001). In the on-demand-PLX study group, a successful harvest greater than 5 × 106/kg in max three aphereses was observed in 85.5% of patients versus 62.3% of patients in the historical control group, (p=0.0001). In the on-demand-PLX study group, 4.3% (6/138) of patients had febrile complications. Salvage mobilization in the on-demand PLX study group was 1.4%. In conclusions, on-demand PLX + CTX 2 g/m2 + G-CSF 10 μg/kg has higher efficacy and lower toxicity compared with CTX 4 g/m2 + G-CSF. An analysis of costs is presented.
AB - In CD34+ cells mobilization of patients with multiple myeloma (MM), the use of Cyclophosphamide (CTX) at a dose of 2 g/m2 has low efficacy although also lower toxicity. The suboptimal mobilizing effect of low-dose CTX, however, may be overcome by plerixafor (PLX) on demand. We conducted a prospective multicenter study in 138 patients with MM to evaluate CTX 2 g/m2 in association with granulocyte-colony stimulating factor (G-CSF) and on-demand PLX. We compared results with a historical group of MM patients (n = 138) mobilized using CTX at a dose of 4 g/m2. CD34+ cells greater than 2 × 106/kg in max three aphereses were harvested in 98.6% of patients in the on-demand PLX study group while in 84.0% in the historical group, (p = 0.0001). In the on-demand-PLX study group, a successful harvest greater than 5 × 106/kg in max three aphereses was observed in 85.5% of patients versus 62.3% of patients in the historical control group, (p=0.0001). In the on-demand-PLX study group, 4.3% (6/138) of patients had febrile complications. Salvage mobilization in the on-demand PLX study group was 1.4%. In conclusions, on-demand PLX + CTX 2 g/m2 + G-CSF 10 μg/kg has higher efficacy and lower toxicity compared with CTX 4 g/m2 + G-CSF. An analysis of costs is presented.
UR - http://www.scopus.com/inward/record.url?scp=85095429318&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095429318&partnerID=8YFLogxK
U2 - 10.1016/j.lrr.2020.100227
DO - 10.1016/j.lrr.2020.100227
M3 - Article
AN - SCOPUS:85095429318
VL - 14
JO - Leukemia Research Reports
JF - Leukemia Research Reports
SN - 2213-0489
M1 - 100227
ER -