Stem Cell Mobilization Performed with Different Doses of Cytarabine in Plasma Cell Myeloma Patients Relapsing after Previous Autologous Hematopoietic Cell Transplantation-A Multicenter Report by the Polish Myeloma Study Group.

Autor: Drozd-Sokołowska J; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Waszczuk-Gajda A; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Topczewska M; Faculty of Computer Science, Bialystok University of Technology, 15-351 Bialystok, Poland., Maciejewska M; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Dutka M; Department of Hematology and Transplantology, Medical University of Gdansk, 80-214 Gdansk, Poland., Zaucha JM; Department of Hematology and Transplantology, Medical University of Gdansk, 80-214 Gdansk, Poland., Szmigielska-Kapłon A; Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland., Nowicki M; Department of Hematology, Medical University of Lodz, 93-513 Lodz, Poland., Olszewska-Szopa M; Department of Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland., Szeremet A; Department of Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland., Czyż A; Department of Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland., Kozioł M; Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland., Hus M; Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland., Mańko J; Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland.; Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, 02-507 Warsaw, Poland., Hus I; Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland.; Department of Hematology, National Medical Institute of the Ministry of Interior and Administration, 02-507 Warsaw, Poland., Romejko-Jarosińska J; Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland., Kopińska A; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Poland., Helbig G; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Poland., Mądry K; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Boguradzki P; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Król M; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Snarski E; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.; Faculty of Medicine and Health Science, University of Zielona Góra, 65-046 Zielona Góra, Poland., Hayden PJ; Department of Haematology, Trinity College Dublin, St. James's Hospital, D08 NHY1 Dublin, Ireland., Jamroziak K; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Dwilewicz-Trojaczek J; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland., Basak GW; Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Jul 19; Vol. 16 (14). Date of Electronic Publication: 2024 Jul 19.
DOI: 10.3390/cancers16142588
Abstrakt: Salvage autologous hematopoietic cell transplantation (auto-HCT) may be used to treat relapse of plasma cell myeloma occurring after previous auto-HCT. When an insufficient number of hematopoietic stem cells have been stored from the initial harvest, remobilization is necessary. Here, we aimed to analyze the efficacy and safety of different doses of cytarabine (total 800 vs. 1600 vs. 2400 mg/m 2 ) for remobilization. Sixty-five patients, 55% male, with a median age at remobilization 63 years, were included. Remobilization was performed with cytarabine_800 in 7, cytarabine_1600 in 36, and cytarabine_2400 in 22 patients. Plerixafor rescue was used in 25% of patients receiving cytarabine_1600 and 27% of those receiving cytarabine_2400. Patients administered cytarabine_800 were not rescued with plerixafor. Remobilization was successful in 80% of patients (57% cytarabine_800; 86% cytarabine_1600; 77% cytarabine_2400; p = 0.199). The yield of collected CD34+ cells did not differ between the different cytarabine doses ( p = 0.495). Patients receiving cytarabine_2400 were at the highest risk of developing severe cytopenias, requiring blood product support, or having blood-stream infections. One patient died of septic shock after cytarabine_2400. In summary, remobilization with cytarabine is feasible in most patients. All doses of cytarabine allow for successful remobilization. Cytarabine_2400 is associated with higher toxicity; therefore, lower doses (800 or 1600 mg/m 2 ) seem to be preferable.
Databáze: MEDLINE
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