Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma: Report of a phase II trial

S. Gupta, P. Zhou, H. Hassoun, T. Kewalramani, L. Reich, S. Costello, L. Drake, V. Klimek, M. Dhodapkar, J. Teruya-Feldstein, C. Hedvat, N. Kalakonda, M. Fleisher, D. Filippa, J. Qin, Stephen D Nimer, R. L. Comenzo

Research output: Contribution to journalArticle

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Abstract

Multiple myeloma (MM) is an incurable hematologic malignancy for which autologous hematopoietic stem cell transplantation (HCT) is a standard therapy. The optimal method of stem cell mobilization is not defined. We evaluated intravenous melphalan (60 mg/m2), the most effective agent for MM, and G-CSF (10 μg/kg/day) for mobilization. End points were safety, adequacy of CD34 + collections, MM response, and contamination of stem cell components (SCC). In total, 32 patients were mobilized. There were no deaths or significant bleeding episodes; 14 patients (44%) required hospitalization for neutropenic fever. Median days of grade 3 or 4 neutropenia or thrombocytopenia were 7 (2-20) and 8 (3-17). Median mobilization days, CD34 + cells/kg and total leukaphereses were 16 (12-30), 12.1 million (2.6-52.8), and 2 (1-5) respectively. Four patients (12.5 %) failed to achieve the target of 4 million CD34 + cells/kg in five leukaphereses. Reduction in myeloma was seen in 11 patients (34%) with 3 (9%) achieving complete response; 15 (47%) maintained prior responses. Estimated MM contamination per SCC (N=48) was 0.0009% (range 0-0.1) and 0.21 × 10 4 cells per kg (range 0-41.2). Increased contamination was associated with increased patient age. This strategy for mobilization is feasible, frequently requires hospitalization and transfusion, and controls disease in most patients.

Original languageEnglish
Pages (from-to)441-447
Number of pages7
JournalBone Marrow Transplantation
Volume35
Issue number5
DOIs
StatePublished - Mar 1 2005
Externally publishedYes

Fingerprint

Hematopoietic Stem Cell Mobilization
Melphalan
Granulocyte Colony-Stimulating Factor
Multiple Myeloma
Leukapheresis
Cellular Structures
Hospitalization
Stem Cells
Hematopoietic Stem Cell Transplantation
Hematologic Neoplasms
Neutropenia
Thrombocytopenia
Fever
Hemorrhage
Safety

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma : Report of a phase II trial. / Gupta, S.; Zhou, P.; Hassoun, H.; Kewalramani, T.; Reich, L.; Costello, S.; Drake, L.; Klimek, V.; Dhodapkar, M.; Teruya-Feldstein, J.; Hedvat, C.; Kalakonda, N.; Fleisher, M.; Filippa, D.; Qin, J.; Nimer, Stephen D; Comenzo, R. L.

In: Bone Marrow Transplantation, Vol. 35, No. 5, 01.03.2005, p. 441-447.

Research output: Contribution to journalArticle

Gupta, S, Zhou, P, Hassoun, H, Kewalramani, T, Reich, L, Costello, S, Drake, L, Klimek, V, Dhodapkar, M, Teruya-Feldstein, J, Hedvat, C, Kalakonda, N, Fleisher, M, Filippa, D, Qin, J, Nimer, SD & Comenzo, RL 2005, 'Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma: Report of a phase II trial', Bone Marrow Transplantation, vol. 35, no. 5, pp. 441-447. https://doi.org/10.1038/sj.bmt.1704779
Gupta, S. ; Zhou, P. ; Hassoun, H. ; Kewalramani, T. ; Reich, L. ; Costello, S. ; Drake, L. ; Klimek, V. ; Dhodapkar, M. ; Teruya-Feldstein, J. ; Hedvat, C. ; Kalakonda, N. ; Fleisher, M. ; Filippa, D. ; Qin, J. ; Nimer, Stephen D ; Comenzo, R. L. / Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma : Report of a phase II trial. In: Bone Marrow Transplantation. 2005 ; Vol. 35, No. 5. pp. 441-447.
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abstract = "Multiple myeloma (MM) is an incurable hematologic malignancy for which autologous hematopoietic stem cell transplantation (HCT) is a standard therapy. The optimal method of stem cell mobilization is not defined. We evaluated intravenous melphalan (60 mg/m2), the most effective agent for MM, and G-CSF (10 μg/kg/day) for mobilization. End points were safety, adequacy of CD34 + collections, MM response, and contamination of stem cell components (SCC). In total, 32 patients were mobilized. There were no deaths or significant bleeding episodes; 14 patients (44{\%}) required hospitalization for neutropenic fever. Median days of grade 3 or 4 neutropenia or thrombocytopenia were 7 (2-20) and 8 (3-17). Median mobilization days, CD34 + cells/kg and total leukaphereses were 16 (12-30), 12.1 million (2.6-52.8), and 2 (1-5) respectively. Four patients (12.5 {\%}) failed to achieve the target of 4 million CD34 + cells/kg in five leukaphereses. Reduction in myeloma was seen in 11 patients (34{\%}) with 3 (9{\%}) achieving complete response; 15 (47{\%}) maintained prior responses. Estimated MM contamination per SCC (N=48) was 0.0009{\%} (range 0-0.1) and 0.21 × 10 4 cells per kg (range 0-41.2). Increased contamination was associated with increased patient age. This strategy for mobilization is feasible, frequently requires hospitalization and transfusion, and controls disease in most patients.",
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T1 - Hematopoietic stem cell mobilization with intravenous melphalan and G-CSF in patients with chemoresponsive multiple myeloma

T2 - Report of a phase II trial

AU - Gupta, S.

AU - Zhou, P.

AU - Hassoun, H.

AU - Kewalramani, T.

AU - Reich, L.

AU - Costello, S.

AU - Drake, L.

AU - Klimek, V.

AU - Dhodapkar, M.

AU - Teruya-Feldstein, J.

AU - Hedvat, C.

AU - Kalakonda, N.

AU - Fleisher, M.

AU - Filippa, D.

AU - Qin, J.

AU - Nimer, Stephen D

AU - Comenzo, R. L.

PY - 2005/3/1

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N2 - Multiple myeloma (MM) is an incurable hematologic malignancy for which autologous hematopoietic stem cell transplantation (HCT) is a standard therapy. The optimal method of stem cell mobilization is not defined. We evaluated intravenous melphalan (60 mg/m2), the most effective agent for MM, and G-CSF (10 μg/kg/day) for mobilization. End points were safety, adequacy of CD34 + collections, MM response, and contamination of stem cell components (SCC). In total, 32 patients were mobilized. There were no deaths or significant bleeding episodes; 14 patients (44%) required hospitalization for neutropenic fever. Median days of grade 3 or 4 neutropenia or thrombocytopenia were 7 (2-20) and 8 (3-17). Median mobilization days, CD34 + cells/kg and total leukaphereses were 16 (12-30), 12.1 million (2.6-52.8), and 2 (1-5) respectively. Four patients (12.5 %) failed to achieve the target of 4 million CD34 + cells/kg in five leukaphereses. Reduction in myeloma was seen in 11 patients (34%) with 3 (9%) achieving complete response; 15 (47%) maintained prior responses. Estimated MM contamination per SCC (N=48) was 0.0009% (range 0-0.1) and 0.21 × 10 4 cells per kg (range 0-41.2). Increased contamination was associated with increased patient age. This strategy for mobilization is feasible, frequently requires hospitalization and transfusion, and controls disease in most patients.

AB - Multiple myeloma (MM) is an incurable hematologic malignancy for which autologous hematopoietic stem cell transplantation (HCT) is a standard therapy. The optimal method of stem cell mobilization is not defined. We evaluated intravenous melphalan (60 mg/m2), the most effective agent for MM, and G-CSF (10 μg/kg/day) for mobilization. End points were safety, adequacy of CD34 + collections, MM response, and contamination of stem cell components (SCC). In total, 32 patients were mobilized. There were no deaths or significant bleeding episodes; 14 patients (44%) required hospitalization for neutropenic fever. Median days of grade 3 or 4 neutropenia or thrombocytopenia were 7 (2-20) and 8 (3-17). Median mobilization days, CD34 + cells/kg and total leukaphereses were 16 (12-30), 12.1 million (2.6-52.8), and 2 (1-5) respectively. Four patients (12.5 %) failed to achieve the target of 4 million CD34 + cells/kg in five leukaphereses. Reduction in myeloma was seen in 11 patients (34%) with 3 (9%) achieving complete response; 15 (47%) maintained prior responses. Estimated MM contamination per SCC (N=48) was 0.0009% (range 0-0.1) and 0.21 × 10 4 cells per kg (range 0-41.2). Increased contamination was associated with increased patient age. This strategy for mobilization is feasible, frequently requires hospitalization and transfusion, and controls disease in most patients.

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