Sanjay de Mel1, Yunxin Chen2, Adeline Lin3, Teck Guan Soh4, Melissa Ooi3, Eng Soo Yap3, Lara Kristina Sioco Donato2, Nurul Aidah Abdul Halim2, Joanna Mah4, Karen Lim4, Li Mei Poon3, Belinda Tan3, Hui Li Lim3, Liang Piu Koh3, Bee Choo Tai5, Zhaojin Chen6, Wee Joo Chng3, Satish Kumar Gopalakrishnan2, Lip Kun Tan7. 1. Department of Haematology-Oncology National University Cancer Institute, National University Health System, Singapore. Electronic address: sanjay_widanalage@nuhs.edu.sg. 2. Department of Haematology, Singapore General Hospital, Singapore. 3. Department of Haematology-Oncology National University Cancer Institute, National University Health System, Singapore. 4. Department of Laboratory Medicine, National University Health System, Singapore. 5. Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Investigational Medicine Unit, National University Health System, Singapore. 6. Investigational Medicine Unit, National University Health System, Singapore. 7. Department of Haematology-Oncology National University Cancer Institute, National University Health System, Singapore; Department of Laboratory Medicine, National University Health System, Singapore.
Abstract
BACKGROUND: High dose Cyclophosphamide (Cy) and Vinorelbine Cyclophosphamide (Vino-Cy) are stem cell (SC) mobilisation options for patients with multiple myeloma (MM). We present a comparison of mobilisation outcomes using these regimens. PATIENTS AND METHODS: Vino-Cy patients received Vinorelbine 25 mg/m2 on day 1, cyclophosphamide 1500 mg/m2 on day 2, and pegylated GCSF on day 4 or GCSF 10 mcg/kg/day from day 4 onwards. Cy patients were given cyclophosphamide 4000 mg/m2 on day 1 and GCSF10 mcg/kg/day from day 5 onwards. The target CD34 + SC collection was 5 × 106 per kg/BW. RESULTS: 149 patients were included. SC collection was lower in the Vino-Cy group (8.20 × 106/Kg BW) compared to the Cy group (11.43 × 106/Kg BW), with adjusted geometric mean ratio of 0.59 (95% CI 0.41 to 0.86, p = 0.006). Time taken to achieve an adequate PB SC count was shorter for Vino-Cy (9 ± 1 day compared to 12 ± 2 days for Cy, adjusted absolute mean difference -3.95, 95% CI -4.85 to -3.06, P < .001). Mobilisation related toxicities (in particular, neutropaenic fever) were greater for Cy. CONCLUSION: Vino-Cy is a potential alternative to Cy given the need for effective mobilisation protocols with acceptable toxicity.
BACKGROUND: High dose Cyclophosphamide (Cy) and Vinorelbine Cyclophosphamide (Vino-Cy) are stem cell (SC) mobilisation options for patients with multiple myeloma (MM). We present a comparison of mobilisation outcomes using these regimens. PATIENTS AND METHODS: Vino-Cypatients received Vinorelbine 25 mg/m2 on day 1, cyclophosphamide 1500 mg/m2 on day 2, and pegylated GCSF on day 4 or GCSF 10 mcg/kg/day from day 4 onwards. Cypatients were given cyclophosphamide 4000 mg/m2 on day 1 and GCSF10 mcg/kg/day from day 5 onwards. The target CD34 + SC collection was 5 × 106 per kg/BW. RESULTS: 149 patients were included. SC collection was lower in the Vino-Cy group (8.20 × 106/Kg BW) compared to the Cy group (11.43 × 106/Kg BW), with adjusted geometric mean ratio of 0.59 (95% CI 0.41 to 0.86, p = 0.006). Time taken to achieve an adequate PB SC count was shorter for Vino-Cy (9 ± 1 day compared to 12 ± 2 days for Cy, adjusted absolute mean difference -3.95, 95% CI -4.85 to -3.06, P < .001). Mobilisation related toxicities (in particular, neutropaenic fever) were greater for Cy. CONCLUSION:Vino-Cy is a potential alternative to Cy given the need for effective mobilisation protocols with acceptable toxicity.