Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Mobilization

A comparison of toxicity following two different doses of cyclophosphamide for mobilization of peripheral blood progenitor cells in 116 multiple myeloma patients

Bone Marrow Transplantation volume 27, pages 837–842 (2001)Cite this article

Abstract

High-dose cyclophosphamide (HDC) has been shown to be an effective regimen for collecting PBPC in multiple myeloma (MM) patients, but the optimal dose to be used remains controversial. Two historical cohorts of MM patients who received G- or GM-CSF and HDC at the dose of either 7 g/m2 (HDC7, n = 74) or 4 g/m (HDC4, n = 42) were compared. As patients in the HDC4 group were more likely to have received G-CSF than GM-CSF (P < 10−3) and fewer previous alkylating agents (P = 0.004), multivariate logistic regression analysis was performed. In the HDC4 group, patients had a shorter median duration of neutropenia (P < 10−4), fewer RBC (P < 10−3) and platelet transfusions (P < 10−3) with fewer patients with platelets <20 × 109/l (P = 0.004). Moreover, fewer febrile episodes (P < 10−3) and less need of intravenous antibiotics (P < 10−3) were found in the HDC4 group. No statistical difference was observed with regard to CD34+ cell collection efficiency. Thus, the use of HDC at the dose of 4 g/m2 for the collection of PBPC in MM patients decreases hematological and extrahematological toxicity with an equivalent CD34+ cell collection efficiency. Bone Marrow Transplantation (2001) 27, 837–842.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Barlogie B, Epstein J, Selvanayagam P, Alexanian R . Plasma cell myeloma new insights and advances in therapy Blood 1989 73: 865–879

    CAS  PubMed  Google Scholar 

  2. Attal M, Harrousseau JL, Stoppa AM et al. High-dose therapy in multiple myeloma: a prospective randomized study of the Intergroupe Français du Myelome New Engl J Med 1996 335: 91–97

    Article  CAS  Google Scholar 

  3. Sheridan WP, Begley CG, Juttner CA et al. Effect of peripheral blood progenitor cells mobilized by filgrastim (G-CSF) on platelet recovery after high dose chemotherapy Lancet 1992 339: 640–644

    Article  CAS  Google Scholar 

  4. Shpall E, Champlin R, Glaspy JA . Effect of CD34+ peripheral blood progenitor cell dose on hematopoietic recovery Biol Blood Marrow Transplant 1998 4: 84–92

    Article  CAS  Google Scholar 

  5. Gianni AM, Siena S, Bregni M et al. Granulocyte-macrophage colony- stimulating factor to harvest circulating haematopoietic stem cells for autotransplantation Lancet 1989 2: 580–585

    Article  CAS  Google Scholar 

  6. Boiron JM, Marit G, Faberes C et al. Collection of peripheral blood stem cells in multiple myeloma following single dose cyclophosphamide with or without recombinant human granulocyte–macrophage colony-stimulating factor Bone Marrow Transplant 1993 12: 49–55

    CAS  PubMed  Google Scholar 

  7. Marit G, Thiessard F, Faberes C et al. Factors influencing both peripheral blood progenitor cell mobilisation and hematopoietic recovery following autologous blood progenitor cell transplantation in multiple myeloma patients: a monocentric study Leukemia 1998 12: 1447–1456

    Article  CAS  Google Scholar 

  8. Durie BGM, Salmon SE . Multiple myeloma, macroglobulinemia and monoclonal gammopathies In: Hoffbrand AV, Brain MC, Hirsh J (eds) Recent Advances in Haematology Churchill Livingstone: New York 1977 pp 243–247

    Google Scholar 

  9. Barlogie B, Smith L, Alexanian R . Effective treatments of advanced multiple myeloma refractory to alkylating agents New Engl J Med 1984 310: 1353–1357

    Article  CAS  Google Scholar 

  10. Alexanian R, Bonnet J, Gehan E et al. Combination chemotherapy for multiple myeloma Cancer 1972 2: 382–389

    Article  Google Scholar 

  11. Miller AB, Hoogstraten B, Staquet M et al. Reporting results of cancer treatments Cancer 1981 47: 207–214

    Article  CAS  Google Scholar 

  12. Siena S, Bregni M, Brando B et al. Flow cytometry for clinical estimation of circulating hematopoietic progenitors for autologous transplantation in cancer patients Blood 1991 27: 22–27

    Google Scholar 

  13. Bouzgarrou R, Cristol G, Hau F et al. Cryopreservation of haematopoietic peripheral blood stem cells in Gambro freezing bags; infusion of peripheral blood stem cells from the peripheral blood In: Areman E, Deegs HJ, Sacher RA (eds) Bone Marrow and Stem Cell Processing: a Manual of Current Techniques FA Davis: Philadelphia 1992 pp 357–363

    Google Scholar 

  14. Mandelli F, Avisati G, Amadori S et al. Maintenance treatment with recombinant interferon alpha 2b in patients with multiple myeloma responding to conventional induction chemotherapy New Engl J Med 1990 322: 1430–1434

    Article  CAS  Google Scholar 

  15. Hosmer DW, Lemeshow S . Applied Survival Analysis: Regression Modeling of Time to Event Data Wiley-Interscience: New York 1999

    Google Scholar 

  16. Scheef W, Klein HO, Brock N et al. Controlled clinical studies with an antidote against the urotoxicity of oxazaphosphorines: preliminary results Cancer Treat Rep 1979 63: 501–505

    CAS  PubMed  Google Scholar 

  17. Prince HM, Imrie K, Sutherland DR et al. Peripheral blood progenitor cell collections in multiple myeloma: predictors and management of inadequate collections Br J Haematol 1996 93: 142–145

    Article  CAS  Google Scholar 

  18. Koç O, Gerson S, Cooper B et al. Randomized cross-over trial of progenitor-cell mobilization: high-dose cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) versus granulocyte–macrophage colony-stimulating factor plus G-CSF J Clin Oncol 2000 18: 1824–1830

    Article  Google Scholar 

  19. Kotasek D, Sherpherd SM, Sage RE et al. Factors affecting blood stem cell collections following high-dose cyclophosphamide mobilisation in lymphoma, myeloma, and solid tumors Bone Marrow Transplant 1992 9: 11–17

    CAS  Google Scholar 

  20. Rowlings PA, Bayly JL, Rawling CM et al. A comparison of peripheral blood stem cell mobilisation after chemotherapy with cyclophosphamide as a single agent in doses of 4 g/m2 or 7 g/m2 in patients with advanced cancer Aust NZ J Med 1992 22: 660–664

    Article  CAS  Google Scholar 

  21. Tarella C, Boccadoro M, Omede P et al. Role of chemotherapy and GM-CSF on hematopoietic progenitor cell mobilisation in multiple myeloma Bone Marrow Transplant 1993 11: 271–277

    CAS  PubMed  Google Scholar 

  22. Bensiger G, Jagabbath S, Vesole DH et al. Factors that influence collection and engraftment of autologous peripheral blood stem cells J Clin Oncol 1995 10: 2547–2555

    Article  Google Scholar 

  23. Demuynck H, Delforge M, Verhoef G et al. Comparative study of peripheral blood progenitor cell collection in patients with multiple myeloma after single-dose cyclophosphamide combined with rhGM-CSF or rhG-CSF Br J Haematol 1995 90: 384–392

    Article  CAS  Google Scholar 

  24. Goldschmidt H, Hegenbart U, Haas R, Hunstein W . Mobilisation of peripheral blood progenitor cells with high-dose cyclophosphamide (4 or 7 g/m2) and granulocyte colony-stimulating factor in patients with multiple myeloma BoneMarrow Transplant 1996 17: 691–697

    CAS  Google Scholar 

  25. Bregni M, Siena S, Di Nicola M et al. Comparative effects of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor after high-dose cyclophosphamide cancer therapy J Clin Oncol 1996 14: 628–635

    Article  CAS  Google Scholar 

  26. Dreger P, Kloss M, Petersen B et al. Autologous progenitor cell transplantation: prior exposure to stem cell-toxic drugs determines yield and engraftment of peripheral blood progenitor cells but not of bone marrow grafts Blood 1995 86: 3970–3978

    CAS  PubMed  Google Scholar 

  27. Facon T, Harousseau JL, Maloisel F et al. Stem cell factor in combination with filgrastim after chemotherapy improves peripheral blood progenitor cell yield and reduces apheresis requirements in multiple myeloma patients: a randomized, controlled trial Blood 1999 4: 1218–1225

    Google Scholar 

Download references

Acknowledgements

We are grateful to Mr Cook for the careful review of the manuscript.

Author information

Authors and Affiliations

  1. Bone Marrow Transplant Unit, CHU Bordeaux, France

    O Fitoussi, V Perreau, JM Boiron, P Cony-Makhoul, A Pigneux, P Agape, F Nicolini, J Reiffers & G Marit

  2. Biostatistical Unit, University Victor Segalen Bordeaux 2, France

    E Bouzigon & R Salmi

  3. EFS (Etablissement Français du Sang, Aquitaine, Limousin), France

    B Dazey

Authors
  1. O Fitoussi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V Perreau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. JM Boiron
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E Bouzigon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P Cony-Makhoul
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A Pigneux
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P Agape
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. F Nicolini
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. B Dazey
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J Reiffers
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. R Salmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. G Marit
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fitoussi, O., Perreau, V., Boiron, J. et al. A comparison of toxicity following two different doses of cyclophosphamide for mobilization of peripheral blood progenitor cells in 116 multiple myeloma patients. Bone Marrow Transplant 27, 837–842 (2001). https://doi.org/10.1038/sj.bmt.1702879

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702879

Keywords

This article is cited by

Search

Advanced search

Quick links