| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2101864 | Biology of Blood and Marrow Transplantation | 2015 | 7 Pages |
•Vinorelbine/granulocyte colony–stimulating factor results in successful collection of hematopoietic progenitor cells in 95% of multiple myeloma patients.•The favorable toxicity profile enhances patient comfort.•A high predictability allows optimal timing of the collection procedure.•Lenalidomide pretreatment is an independent negative factor for hematopoietic progenitor cells collection.
We aimed to assess the efficacy of vinorelbine plus granulocyte colony–stimulating factor (G-CSF) for chemo-mobilization of CD34+ hematopoietic progenitor cells (HPC) in patients with multiple myeloma and to identify adverse risk factors for successful mobilization. Vinorelbine 35 mg/m2 was administered intravenously on day 1 in an outpatient setting. Filgrastim 5 μg/kg body weight (BW) was given twice daily subcutaneously from day 4 until the end of the collection procedure. Leukapheresis was scheduled to start on day 8 and be performed for a maximum of 3 consecutive days until at least 4 × 106 CD34+ cells per kg BW were collected. Overall, 223 patients were mobilized and 221 (99%) patients proceeded to leukapheresis. Three (1.5%) patients required an unscheduled hospitalization after chemo-mobilization because of neutropenic fever and renal failure (n = 1), severe bone pain (n = 1), and abdominal pain with constipation (n = 1). In 211 (95%) patients, the leukaphereses were started as planned at day 8, whereas in 8 (3%) patients the procedure was postponed to day 9 and in 2 (1%) patients to day 10. In the great majority of patients (77%), the predefined amount of HPC could be collected with 1 leukapheresis. Forty-four (20%) patients needed a second leukapheresis, whereas only 6 (3%) patients required a third leukapheresis procedure. The median number of CD34+ cells collected was 6.56 × 106 (range, .18 to 25.9 × 106) per kg BW at the first day of leukapheresis and 7.65 × 106 (range, .18 to 25.9 × 106) per kg BW in total. HPC collection was successful in 212 (95%) patients after a maximum of 3 leukaphereses. Patient age (P = .02) and prior exposition to lenalidomide (P < .001) were independent risk factors for a lower HPC amount collected in multiple regression analysis. Vinorelbine plus G-CSF enables a very reliable prediction of the timing of leukapheresis and results in successful HPC collection in 95% of the patients.
