Selection of a mobilization regimen for multiple myeloma based on the response to induction therapy: granulocyte-colony stimulating factor (G-CSF) alone versus high-dose cyclophosphamide plus G-CSF.

Abstract

To evaluate the feasibility of selecting amobilizationregimenbasedon theresponsetoinductiontherapy, we retrospectively analyzed 179multiplemyelomapatients who underwent stem cellmobilization. In comparison with patients who achieved at least a very good partialresponse(VGPR) toinductiontherapyand receivedgranulocyte-colonystimulatingfactor(G-CSF)aloneand patients who did not achieve a VGPR and receivedcyclophosphamide(CY) + G-CSF, treatment-related toxicity was greater and neutrophil engraftment was slower in the CY than theG-CSFgroup. The rate of requisitemobilization(≥ 2.0 × 10(6)/kg) was similar in both groups. Overall and progression-free survival was not different between patients in theG-CSFgroup and patients who achieved at least VGPR and received CY + G-CSF. In conclusion,response-adaptedselectionof amobilizationregimenis appropriate.G-CSFaloneshould be the preferred treatment for patients who achieved at least a VGPR toinductiontherapy.