GCSF ALONE STEM CELL MOBILIZATION IN MULTIPLE MYELOMA PATIENTS CANDIDATES TO HIGH DOSE CHEMOTHERAPY: A MONOCENTRIC RETROSPECTIVE EXPERIENCE.
Author(s): ,
Stefania Bramanti
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Filippo Magri
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Laura Giordano
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Barbara Sarina
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Lucio Morabito
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Jacopo Mariotti
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Chiara De Philippis
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Daniele Girardi
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Inna Timofeeva
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Rossana Capizzuto
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Rita Mazza
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Carmelo Carlo-Stella
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
,
Armando Santoro
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
Luca Castagna
Affiliations:
Hematology,Istituto Clinico Humanitas,Rozzano,Italy
EHA Library. Bramanti S. Jun 15, 2019; 267045; PS1428
Stefania Bramanti
Stefania Bramanti
Contributions
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Abstract

Abstract: PS1428

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Despite the introduction of several effective multidrug combination in the treatment landscape of multiple myeloma (MM), high dose chemotherapy (HDC) is still an important phase in the treatment of MM. On the other hand, chemotherapy used to mobilize stem cell (SC) do not contribute in disease control or long term survival

Aims

To analyze the efficacy of granulocyte colony stimulating factor (GCSF) alone to mobilize SC, in a consecutive series of multiple myeloma patients candidate to HDC.

Methods

From January 2016 to January 2019, 61 consecutive MM patients underwent GCSF alone stem cell mobilization in our institution. Every patients received GCSF at the dose of 10 mcg/kg/day for 5 days. Peripheral blood circulating CD34+/mcl were checked from day +4. Plerixafor was administered on demand when CD34+ cells were less than 20/mcl at day +4 or +5, or when CD34 harvested was less than 2 ×10^6/kg after the first or second apheresis.  The stem cell harvest were performed processing 2.5 − 3 times total blood volume. After collection, the patients received single or double course of melphalan 200 mg/m2 or 1 course of melphalan 140 mg/m2 according to local guideline. The minimal CD34+ number to perform a single HDC was 2x106/kg.

Results
Patient characteristics are listed in Table 1. All patients but 2 (3%) achieved the target to perform the planned HCD. Median total CD34+×106/kg harvested was 8.6. The proportion of patients able to achieve the goal with one apheresis was 50%. Only 1 patient underwent a third apheresis. Nine patients (14%) received plerixafor, 7 on day +4 and 2 on day +5. Median blood CD34+/mcl on day+4 and +5 was 33.5 (15-98), and 63 (10-171), respectively. Median total blood leucocyte counts (10^3/mm^3) on day 4+ and on day +5 was 41310 and 49250, respectively. Median CD34+×106/kg in the first and second apheresis was 6.4 (0,8-16) and 4.7 (1.5-8), respectively. Median total leucocyte count (106) in the graft on first and second apheresis was respectively 71280 and 49250. After HDC, all patients but one experienced engraftment.

Conclusion

GCSF alone stem cell mobilization is an effective and safe approach after induction in MM patients candidate to HDC. The main advantages are the possibility to predict peak CD34+ level (4-5 days), to schedule apheresis in an outpatient program and to avoid unnecessary toxicity with chemotherapy.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Mobilization, Multiple myeloma

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