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Recombinant human thrombopoietin improves the efficacy of intermediate-dose cyclophosphamide plus granulocyte colony-stimulating factor in mobilizing peripheral blood stem cells in patients with multiple myeloma: A cohort study.

Abstract The combination of intermediate-dose cyclophosphamide (ID-CTX) and granulocyte colony-stimulating factor (G-CSF) fails to mobilize peripheral blood stem cells (PBSCs) in approximately 20% of treated patients with multiple myeloma (MM).In this cohort study, patients with MM underwent PBSC mobilization with either an ID-CTX plus G-CSF plus recombinant human thrombopoietin (rhTPO) regimen (72 patients; TPO group), or an ID-CTX plus G-CSF regimen (70 patients; non-TPO group).In the TPO group, the median CD34+ harvest was 5.36 × 10 per kg of body weight (0.50-22.39 × 10 per kg of body weight), with a harvest success rate of 91.7% (66/72), and an excellence rate of 55.6% (40/72). In the non-TPO group, the median CD34+ harvest was 3.30 × 10 per kg of body weight (0.20-21.14 × 10 per kg of body weight), with a harvest success rate of 75.7% (53/70), and an excellence rate of 25.7% (18/70). The median count of the CD34+ cells collected, success rate of collection, and excellence rate of collection were significantly higher in the TPO group than in the non-TPO group (P=.0001, P=.01, and P = .0001, respectively). Time to granulocyte and platelet engraftment was faster among patients in the TPO group than that in those from the non-TPO group. No platelet engraftment delay (>21 days) was observed among patients in the TPO group, while 3 patients in the non-TPO group displayed delayed platelet engraftment.Adding rhTPO to the ID-CTX chemotherapy plus G-CSF regimen improved treatment efficacy in mobilizing PBSCs for autologous hematopoietic stem cell transplantation.
PMID
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Cyclophosphamide plus granulocyte-colony stimulating factor for hematopoietic stem cell mobilization in patients with multiple myeloma.

Authors

Mayor MeshTerms

Drug Synergism

Hematopoietic Stem Cell Transplantation

Keywords
Journal Title medicine
Publication Year Start




PMID- 29390394
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Recombinant human thrombopoietin improves the efficacy of intermediate-dose
      cyclophosphamide plus granulocyte colony-stimulating factor in mobilizing
      peripheral blood stem cells in patients with multiple myeloma: A cohort study.
PG  - e9302
LID - 10.1097/MD.0000000000009302 [doi]
AB  - The combination of intermediate-dose cyclophosphamide (ID-CTX) and granulocyte
      colony-stimulating factor (G-CSF) fails to mobilize peripheral blood stem cells
      (PBSCs) in approximately 20% of treated patients with multiple myeloma (MM).In
      this cohort study, patients with MM underwent PBSC mobilization with either an
      ID-CTX plus G-CSF plus recombinant human thrombopoietin (rhTPO) regimen (72
      patients; TPO group), or an ID-CTX plus G-CSF regimen (70 patients; non-TPO
      group).In the TPO group, the median CD34+ harvest was 5.36 x 10 per kg of body
      weight (0.50-22.39 x 10 per kg of body weight), with a harvest success rate of
      91.7% (66/72), and an excellence rate of 55.6% (40/72). In the non-TPO group, the
      median CD34+ harvest was 3.30 x 10 per kg of body weight (0.20-21.14 x 10 per kg 
      of body weight), with a harvest success rate of 75.7% (53/70), and an excellence 
      rate of 25.7% (18/70). The median count of the CD34+ cells collected, success
      rate of collection, and excellence rate of collection were significantly higher
      in the TPO group than in the non-TPO group (P=.0001, P=.01, and P = .0001,
      respectively). Time to granulocyte and platelet engraftment was faster among
      patients in the TPO group than that in those from the non-TPO group. No platelet 
      engraftment delay (>21 days) was observed among patients in the TPO group, while 
      3 patients in the non-TPO group displayed delayed platelet engraftment.Adding
      rhTPO to the ID-CTX chemotherapy plus G-CSF regimen improved treatment efficacy
      in mobilizing PBSCs for autologous hematopoietic stem cell transplantation.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Wang, Guorong
AU  - Wang G
FAU - Chen, Wenming
AU  - Chen W
FAU - Wu, Yin
AU  - Wu Y
FAU - Li, Yanchen
AU  - Li Y
FAU - Leng, Yun
AU  - Leng Y
FAU - Liu, Aijun
AU  - Liu A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents, Alkylating)
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 9014-42-0 (Thrombopoietin)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents, Alkylating/*therapeutic use
MH  - Cyclophosphamide/*therapeutic use
MH  - *Drug Synergism
MH  - Drug Therapy, Combination
MH  - Female
MH  - Granulocyte Colony-Stimulating Factor/*therapeutic use
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/*drug therapy/pathology
MH  - Neoplasm Staging
MH  - Peripheral Blood Stem Cells/*drug effects
MH  - Thrombopoietin/*therapeutic use
MH  - Treatment Outcome
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009302 [doi]
AID - 00005792-201712150-00144 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e9302. doi: 10.1097/MD.0000000000009302.