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Etoposide combined with cytarabine and pegfilgrastim for poorly mobilizing patients with multiple myeloma and lymphoma: A prospective multicentre study.
- Source :
-
British journal of haematology [Br J Haematol] 2024 Jun; Vol. 204 (6), pp. 2342-2350. Date of Electronic Publication: 2024 Feb 23. - Publication Year :
- 2024
-
Abstract
- A chemotherapy-based mobilization regimen in patients who mobilize poorly, based on etoposide, cytarabine and pegfilgrastim (EAP), has recently been introduced. The aim of this prospective study was to investigate the efficacy and safety of the EAP regimen in patients with poorly mobilizing multiple myeloma (MM) or lymphoma. This single-arm clinical trial was performed at eight public hospitals in China and was registered as a clinical trial (NCT05510089). The inclusion criteria were; (1) diagnosis of MM or lymphoma, (2) defined as a 'poor mobilizer' and (3) aged 18-75 years. The EAP regimen consisted of etoposide 75 mg/m <superscript>2</superscript> /day on days 1-2, cytarabine 300 mg/m <superscript>2</superscript> every 12 h on days 1-2 and pegfilgrastim 6 mg on day 6. The primary endpoint of the study was the ratio of patients achieving adequate mobilization (≥2.0 × 10 <superscript>6</superscript> CD34 <superscript>+</superscript> cells/kg). From 1 September 2022 to 15 August 2023, a total of 58 patients were enrolled, 53 (91.4%) achieved adequate mobilization, while 41 (70.7%) achieved optimal mobilization with a median number of cumulative collected CD34 <superscript>+</superscript> cells was 9.2 (range 2.1-92.7) × 10 <superscript>6</superscript> /kg and the median number of apheresis per patient of 1.2. The median time from administration of the EAP regimen to the first apheresis was 12 days. Approximately 8.6% of patients required plerixa for rescue, which was successful. Twelve (20.7%) of the 58 patients suffered grade 2-3 infections, while 25 (43.1%) required platelet transfusions. The duration of neutrophil and platelet engraftment was 11 days. In conclusion, these results suggest that the EAP mobilization regimen might be a promising option for poorly mobilizing patients with MM or lymphoma.<br /> (© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
- Subjects :
- Humans
Middle Aged
Female
Male
Adult
Prospective Studies
Aged
Young Adult
Adolescent
Filgrastim administration & dosage
Filgrastim therapeutic use
Cytarabine administration & dosage
Cytarabine therapeutic use
Polyethylene Glycols administration & dosage
Etoposide administration & dosage
Etoposide therapeutic use
Lymphoma drug therapy
Lymphoma therapy
Multiple Myeloma drug therapy
Multiple Myeloma therapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Antineoplastic Combined Chemotherapy Protocols adverse effects
Hematopoietic Stem Cell Mobilization methods
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2141
- Volume :
- 204
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 38400570
- Full Text :
- https://doi.org/10.1111/bjh.19367