Jang Ji Eun, Cheong June-Won, Kim Soo-Jeong, Cho Hyunsoo, Suh Cheolwon, Lee Hyewon, Eom Hyeon-Seok, Yhim Ho-Young, Lee Won-Sik, Min Chang-Ki, Lee Jae Hoon, Park Joon Seong, Kim Jin Seok
a Division of Hematology, Department of Internal Medicine , Severance Hospital, Yonsei University College of Medicine , Seoul , Korea ;
b Department of Oncology , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Korea ;
Leuk Lymphoma. 2016;57(6):1389-97. doi: 10.3109/10428194.2015.1102240. Epub 2015 Nov 16.
To evaluate the feasibility of selecting a mobilization regimen based on the response to induction therapy, we retrospectively analyzed 179 multiple myeloma patients who underwent stem cell mobilization. In comparison with patients who achieved at least a very good partial response (VGPR) to induction therapy and received granulocyte-colony stimulating factor (G-CSF) alone and patients who did not achieve a VGPR and received cyclophosphamide (CY) + G-CSF, treatment-related toxicity was greater and neutrophil engraftment was slower in the CY than the G-CSF group. The rate of requisite mobilization (≥ 2.0 × 10(6)/kg) was similar in both groups. Overall and progression-free survival was not different between patients in the G-CSF group and patients who achieved at least VGPR and received CY + G-CSF. In conclusion, response-adapted selection of a mobilization regimen is appropriate. G-CSF alone should be the preferred treatment for patients who achieved at least a VGPR to induction therapy.
为评估根据诱导治疗反应选择动员方案的可行性，我们回顾性分析了179例接受干细胞动员的多发性骨髓瘤患者。与诱导治疗至少达到非常好的部分缓解（VGPR）且仅接受粒细胞集落刺激因子（G-CSF）的患者以及未达到VGPR且接受环磷酰胺（CY）+G-CSF的患者相比，CY组的治疗相关毒性更大，中性粒细胞植入更慢。两组的必要动员率（≥2.0×10⁶/kg）相似。G-CSF组患者与至少达到VGPR并接受CY+G-CSF的患者的总生存期和无进展生存期无差异。总之，根据反应选择动员方案是合适的。对于诱导治疗至少达到VGPR的患者，单独使用G-CSF应是首选治疗方法。
