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Progenitor Cell Mobilisation

Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective

Bone Marrow Transplantation volume 31, pages 99–103 (2003)Cite this article

Summary:

Cyclophosphamide with granulocyte colony stimulating factor (G-CSF) is commonly used to mobilize stem cells in multiple myeloma. Timing of collection is variable and incidence and severity of side effects is substantial. To optimize timing of collection, to reduce side effects and to limit costs of the procedure, we evaluated vinorelbine, a drug shown to have activity in multiple myeloma, in combination with G-CSF as mobilizing regimen. A total of 19 consecutive patients with advanced stage multiple myeloma received one dose of vinorelbine 35 mg/m2 intravenously on day 1 in an outpatient setting and G-CSF 10 μg/kg/day from day 4 divided in two daily doses. Median CD34+ cell blood counts measured on day 8 of mobilization were 142×106/l (range 57–467). One 15-l apheresis on day 8 resulted in sufficient stem cells (median 11.1×106 CD34+ cells/kg, range 6.2–36.0 prior and median 7.5×106 CD34+ cells/kg, range 4.0–20.2 postpositive CD34+ cell selection) for transplantation. Hematopoietic recovery was swift with ANC >0.5×109/l on day 11 median (range 10–15) and platelets >20×109/l on day 12 median (range 10–15) after reinfusion of the stem cells on day 0. No episodes of febrile neutropenia were observed during mobilization. In our institutions cost reduction for the procedure was about 1700 euros compared to the mobilization with cyclophosphamide and G-CSF. Vinorelbine and G-CSF allow precise timing and harvesting of sufficient stem cells, and might be an alternative to cyclophosphamide in the mobilization of stem cells for autologous transplantation in multiple myeloma.

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References

  1. Barlogie B, Alexanian R, Dicke K et al. High dose chemoradiotherapy and autologous bone marrow trans-plantation for resistant multiple myeloma. Blood 1987; 70: 869–872.

    CAS  Google Scholar 

  2. Fermand J-P, Chevret S, Ravaud P et al. High-dose chemoradiotherapy and autologous stem cell transplantation in multiple myeloma: Results of a phase II trial involving 63 patients. Blood 1993; 82: 2005–2009.

    CAS  Google Scholar 

  3. Harousseau J, Attal M, Divine M et al. Autologous stem cell transplantation after first remission induction treatment in multiple myeloma: a report of the French registry on autologous transplantation in multiple myeloma. Blood 1995; 85: 3077–3085.

    CAS  Google Scholar 

  4. Attal M, Harousseau J-L, Stoppa A-M et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. New Engl J Med 1996; 335: 91–97.

    Article  CAS  Google Scholar 

  5. Deskin R, Barlogie B, Sawyer J et al. Results of high-dose therapy for 1000 patients with multiple myeloma: durable complete remissions and superior survival in the absence of chromosome 13 abnormalities. Blood 2000; 95: 4008–4010.

    Google Scholar 

  6. To LB, Shepperd KM, Haylock DN et al. Single high doses of cyclophosphamide enable the collection of high numbers of hemopoietic stem cells from the peripheral blood. Exp Hematol 1990; 18: 442–447.

    CAS  Google Scholar 

  7. Kotasek D, Shepherd KM, Sage RE et al. Factors affecting blood stem cell collections following high-dose cyclophosphamide mobilization in lymphoma, myeloma and solid tumors. Bone Marrow Transplant 1992; 9: 11–17.

    CAS  Google Scholar 

  8. Boiron JM, Marit G, Faberes C et al. Collection of peripheral blood stem cells in multiple myeloma with and without recombinant human granulocyte-macrophage colony-stimulating factor (rh GM-CSF). Bone Marrow Transplant 1993; 12: 49–55.

    CAS  Google Scholar 

  9. Goldschmidt H, Hegenbart U, Haas R et al. Mobilization of peripheral blood progenitor cells with high-dose cyclophosphamide (4 or 7 g/m2) and granulocyte colony-stimulating factor in patients with multiple myeloma. Bone Marrow Transplant 1996; 17: 691–697.

    CAS  Google Scholar 

  10. Deskin R, Barlogie B, Sundar J et al. Comparable engraftment kinetics following peripheral-blood stem-cell infusion mobilized with granulocyte colony-stimulating factor with or without cyclophosphamide in multiple myeloma. J Clin Oncol 1998; 16: 1547–1553.

    Article  Google Scholar 

  11. Harousseau JL, Maloisel F, Sotto JJ et al. Vinorelbine (VRL) in patients with recurrent multiple myelomas (MM): a phase II study. Proc ASCO 1997; 16: 37 (abstr).

    Google Scholar 

  12. Harousseau JL, Dammacco F, San Miguel J et al. An alternative treatment for relapsed/resistant multiple myeloma (MM): Vinorelbine (VRL), plus high-dose dexamethasone (DEX): two phase II studies. Proc ASCO 1999; 18: 107 (abstr).

    Google Scholar 

  13. Magagnoli M, Sarina B, Balzarotti M et al. Mobilizing potential of ifosfamide/vinorelbine-based chemotherapy in pretreated malignant lymphoma. Bone Marrow Transplant 2001; 28: 923–927.

    Article  CAS  Google Scholar 

  14. Durie B, Salmon S . A clinical staging system for multiple myeloma. Cancer 1975; 36: 842–852.

    Article  CAS  Google Scholar 

  15. Mohle R, Murea S, Pforsich M et al. Estimation of the progenitor cell yield in a leukapheresis product by previous measurement of CD34+ cells in the peripheral blood. Vox Sanguinis 1996; 71: 90–96.

    Article  CAS  Google Scholar 

  16. Morrison A-E, Green R-H-A, Watson D et al. Measurement of peripheral blood CD34 counts to optimise the timing of peripheral blood progenitor cell (PBPC) collections for autologous transplants. Br J Haematol 1997; 97 (Suppl 1): 41.

    Google Scholar 

  17. Barnett D, Janossy A, Lubenko A et al. Guideline for the flow cytometric enumeration of CD34+ haematopoietic stem cells. Clin Lab Haem 1999; 21: 301–308.

    Article  CAS  Google Scholar 

  18. Tichelli A, Gratwohl A, Bargetzi M et al. Autologe Transplantation von hämopoietischen Vorläuferzellen nach CD34-Anreicherung. Schweiz Med Wochenschr 1996; 126: 201–206.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Center of Oncology/Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, Switzerland

    M J Bargetzi, E Baertschi, A Schoenenberger, C Gwerder, J Burger, W Mingrone & M Wernli

  2. Department of Internal Medicine, Division of Hematology, University Hospital Basel, Basel, Switzerland

    J Passweg & A Gratwohl

  3. Department of Internal Medicine, Hematology Laboratory, University Hospital Basel, Basel, Switzerland

    A Tichelli

  4. Division of Oncology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland

    R Herrmann

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  1. M J Bargetzi
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  2. J Passweg
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  3. E Baertschi
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  5. C Gwerder
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  6. A Tichelli
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  7. J Burger
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Bargetzi, M., Passweg, J., Baertschi, E. et al. Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective. Bone Marrow Transplant 31, 99–103 (2003). https://doi.org/10.1038/sj.bmt.1703787

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  • DOI: https://doi.org/10.1038/sj.bmt.1703787

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