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Plasma Cell Disorders

Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation

Bone Marrow Transplantation volume 50, pages 1513–1518 (2015)Cite this article

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Abstract

In patients with multiple myeloma (MM) undergoing autologous hematopoietic cell transplantation (auto-HCT), peripheral blood progenitor cells may be collected following mobilization with growth factor alone (GF) or cytotoxic chemotherapy plus GF (CC+GF). It is uncertain whether the method of mobilization affects post-transplant outcomes. We compared these mobilization strategies in a retrospective analysis of 968 patients with MM from the Center for International Blood and Marrow Transplant Research database who received an auto-HCT in the US and Canada between 2007 and 2012. The kinetics of neutrophil engraftment (⩾0.5 × 109/L) was similar between groups (13 vs 13 days, P=0.69) while platelet engraftment (⩾20 × 109/L) was slightly faster with CC+GF (19 vs 18 days, P=0.006). Adjusted 3-year PFS was 43% (95% confidence interval (CI) 38–48) in GF and 40% (95% CI 35–45) in CC+GF, P=0.33. Adjusted 3-year OS was 82% (95% CI 78–86) vs 80% (95% CI 75–84), P=0.43 and adjusted 5-year OS was 62% (95% CI 54–68) vs 60% (95% CI 52–67), P=0.76, for GF and CC+GF, respectively. We conclude that MM patients undergoing auto-HCT have similar outcomes irrespective of the method of mobilization and found no evidence that the addition of chemotherapy to mobilization contributes to disease control.

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Acknowledgements

The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-13-1-0039 and N00014-14-1-0028 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals; Allos Therapeutics, Inc.; *Amgen, Inc.; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; *Blue Cross and Blue Shield Association; *Celgene Corporation; Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc.; *Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.;*Gentium SpA; Genzyme Corporation; GlaxoSmithKline; Health Research, Inc. Roswell Park Cancer Institute; HistoGenetics, Inc.; Incyte Corporation; Jeff Gordon Children’s Foundation; Kiadis Pharma; The Leukemia & Lymphoma Society; Medac GmbH; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; *Milliman USA, Inc.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Perkin Elmer, Inc.; *Remedy Informatics; *Sanofi US; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; St. Baldrick’s Foundation; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; *Tarix Pharmaceuticals; *TerumoBCT; *Teva Neuroscience, Inc.; *THERAKOS, Inc.; University of Minnesota; University of Utah; and *Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government.

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Author notes

  1. G L Uy and L J Costa: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Washington University School of Medicine, St Louis, MO, USA

    G L Uy

  2. Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    L J Costa & A A Saad

  3. Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR®), Medical College of Wisconsin, Milwaukee, WI, USA

    P N Hari, M-J Zhang, J-X Huang, M Hamadani & A D'Souza

  4. Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA

    M-J Zhang

  5. Hematologic Oncology Treatment Center, Dana-Farber Cancer Institute, Boston, MA, USA

    K C Anderson

  6. The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

    C N Bredeson

  7. University of Wisconsin Carbone Cancer Center, Madison, WI, USA

    N S Callander

  8. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    R F Cornell & B N Savani

  9. Servicio de Oncohematologia, Hospital Infantil Universitario Nino Jesus, Madrid, Spain

    M A D Perez

  10. Department of Hematology, Mayo Clinic, Rochester, MN, USA

    A Dispenzieri, M A Gertz, S K Kumar & R A Kyle

  11. South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, TX, USA

    C O Freytes

  12. Division of Experimental Medicine, Department of Medicine, Hematology Research Centre, Imperial College London, London, UK

    R P Gale

  13. Division of Hematology/Oncology, Perelman Center for Advanced Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

    A Garfall, E A Stadtmauer & D T Vogl

  14. Haematology Department, Royal Prince Alfred Hospital Institute of Haematology, Camperdown, New South Wales, Australia

    J Gibson

  15. Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    H M Lazarus

  16. Hematologic Oncology and Blood Disorders, Cleveland Clinic, Cleveland, OH, USA

    M E Kalaycio

  17. Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA

    R T Kamble

  18. Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    M A Kharfan-Dabaja

  19. Department of Hematology/Oncology, City of Hope National Medical Center, Duarte, CA, USA

    A Y Krishnan

  20. Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    H J Landau

  21. Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital/SA Pathology, Adelaide, South Australia, Australia

    C H Lee & L B To

  22. Hospital Universitário Clementinio Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    A Maiolino

  23. Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK

    D I Marks

  24. Department of Medicine, New York Presbyterian Hospital at Cornell, New York, NY, USA

    T M Mark

  25. Department of Internal Medicine, Section of Hematology/Oncology, Louisiana State University Health Shreveport, Shreveport, LA, USA

    R Munker

  26. Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    T Nishihori

  27. Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden

    R F Olsson

  28. Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden

    R F Olsson

  29. Division of Hematology and Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA

    M Ramanathan

  30. Bone Marrow Transplant Program, Loyola University Medical Center, Chicago, IL, USA

    T E Rodriguez

  31. Bone Marrow Transplant Program, UCLA Center for Health Sciences, Los Angeles, CA, USA

    G J Schiller

  32. Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands

    H C Schouten

  33. Cancer Transplant Institute, Virginia G. Piper Cancer Center, Scottsdale, AZ, USA

    J R Schriber

  34. Arizona Oncology, Scottsdale, AZ, USA

    J R Schriber

  35. Center for Hematologic Malignancies, Oregon Health and Science University, Portland, OR, USA

    E Scott

  36. Department of Vaccine and Infectious Disease, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    S Seo

  37. Department of Hematology/Oncology, Thomas Jefferson University, Philadelphia, PA, USA

    M Sharma & J L Wagner

  38. Division of Hematology and Oncology, Blood and Marrow Transplantation, University of Kansas Medical Center, Kansas City, KS, USA

    S Ganguly

  39. Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

    J Tay

  40. Hackensack University Medical Center, Hackensack, NJ, USA

    D H Vesole

  41. Seattle Cancer Care Alliance, Seattle, WA, USA

    B Wirk

  42. Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA

    W A Wood

Authors
  1. G L Uy
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  2. L J Costa
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  3. P N Hari
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  8. N S Callander
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  9. R F Cornell
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  11. A Dispenzieri
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  14. A Garfall
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  22. A Y Krishnan
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  27. A Maiolino
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  28. D I Marks
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  29. T M Mark
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  30. R Munker
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  31. T Nishihori
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  32. R F Olsson
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  33. M Ramanathan
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  34. T E Rodriguez
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  35. A A Saad
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  36. B N Savani
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  37. G J Schiller
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  38. H C Schouten
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  39. J R Schriber
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  40. E Scott
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  41. S Seo
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  42. M Sharma
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  44. E A Stadtmauer
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  45. J Tay
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  46. L B To
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  47. D H Vesole
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  48. D T Vogl
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  49. J L Wagner
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  50. B Wirk
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  51. W A Wood
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  52. A D'Souza
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Corresponding author

Correspondence to A D'Souza.

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The authors declare no conflict of interest.

Additional information

Presented in part at the 56th Annual Meeting of the American Society of Hematology, San Francisco, CA December 6–9, 2014.

Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Uy, G., Costa, L., Hari, P. et al. Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation. Bone Marrow Transplant 50, 1513–1518 (2015). https://doi.org/10.1038/bmt.2015.190

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