Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma

Yong Park; Dae Sik Kim; Min Ji Jeon; Byung Hyun Lee; Eun Sang Yu; Ka Won Kang; Se Ryeon Lee; Hwa Jung Sung; Myung-Hyun Nam; Soo-Young Yoon; Chul Won Choi; Eun Suk Kang; Duck Cho; Kihyun Kim; Byung Soo Kim; Dae Won Kim; Seok Jin Kim

doi:10.1002/jca.21734

Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma

Yong Park, Dae Sik Kim, Min Ji Jeon, Byung Hyun Lee, Eun Sang Yu, Ka Won Kang, Se Ryeon Lee, Hwa Jung Sung, Myung-Hyun Nam, Soo-Young Yoon, Chul Won Choi, Eun Suk Kang, Duck Cho, Kihyun Kim, Byung Soo Kim, Dae Won Kim, Seok Jin Kim

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9 Citations (Scopus)

Abstract

Background: Single-dose etoposide was used an outpatient-based protocol for mobilization in patients with multiple myeloma (MM) for autologous stem cell transplantation (ASCT). Thus, we retrospectively analyzed the efficacy and safety of our one-day protocol in comparison with that of previous methods. Methods: We retrospectively analyzed 168 patients with MM who underwent peripheral blood stem cell collection for upfront ASCT between 2008 and 2018. The mobilization protocols included G-CSF alone (G-mobilization), one-day 375 mg/m² of etoposide (E375), two-days of 375 mg/m² of etoposide (E750), or one-day high-dose (3.5 g/m²) cyclophosphamide (HD CY). For comparison of efficacy of each protocol, collected CD34+ cells over 4 × 10⁶/kg and under 2 × 10⁶/kg were defined as “adequate harvest” and “harvest failure,” respectively. Results: The median number of collected CD34+ cells was 5.58 × 10⁶/kg in patients receiving single-dose etoposide, and the percentage of uncomplicated optimal harvest of E375 (65.6%, 21/32) was significantly higher than that of E750 (41.9%, 13/31) and HD CY (31.3%, 15/48). The E375 showed the highest rate of adequate harvest (96.9%, 31/32) compared to that of E750 (87.1%), HD CY (75.0%), and G-mobilization (59.6%). Most E375 patients achieved adequate harvest without complication (29/32, 90.6%), the CD34+ cell collection yield on apheresis days one and two of E375 was not significantly different from that of E750, and no harvest failures occurred for E375. Neutrophil and platelet engraftments were significantly faster in E375 than other groups (P <.001). Conclusions: The use of single-dose etoposide could be an effective and safe method for mobilization in patients with MM.

Original language	English
Pages (from-to)	579-588
Number of pages	10
Journal	Journal of Clinical Apheresis
Volume	34
Issue number	5
DOIs	https://doi.org/10.1002/jca.21734
Publication status	Published - 2019 Oct 1

Bibliographical note

Funding Information:
This study was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science, and Technology (NRF-2017R1A2B4005136).

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

Keywords

autologous stem cell transplantation
etoposide
mobilization
multiple myeloma

ASJC Scopus subject areas

Hematology

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10.1002/jca.21734

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Park, Y., Kim, D. S., Jeon, M. J., Lee, B. H., Yu, E. S., Kang, K. W., Lee, S. R., Sung, H. J., Nam, M.-H., Yoon, S.-Y., Choi, C. W., Kang, E. S., Cho, D., Kim, K., Kim, B. S., Kim, D. W., & Kim, S. J. (2019). Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma. Journal of Clinical Apheresis, 34(5), 579-588. https://doi.org/10.1002/jca.21734

Park, Y, Kim, DS, Jeon, MJ, Lee, BH, Yu, ES, Kang, KW, Lee, SR, Sung, HJ, Nam, M-H, Yoon, S-Y, Choi, CW, Kang, ES, Cho, D, Kim, K, Kim, BS, Kim, DW & Kim, SJ 2019, 'Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma', Journal of Clinical Apheresis, vol. 34, no. 5, pp. 579-588. https://doi.org/10.1002/jca.21734

@article{541df8040d1b4b9294fad81784aa2f99,

title = "Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma",

abstract = "Background: Single-dose etoposide was used an outpatient-based protocol for mobilization in patients with multiple myeloma (MM) for autologous stem cell transplantation (ASCT). Thus, we retrospectively analyzed the efficacy and safety of our one-day protocol in comparison with that of previous methods. Methods: We retrospectively analyzed 168 patients with MM who underwent peripheral blood stem cell collection for upfront ASCT between 2008 and 2018. The mobilization protocols included G-CSF alone (G-mobilization), one-day 375 mg/m2 of etoposide (E375), two-days of 375 mg/m2 of etoposide (E750), or one-day high-dose (3.5 g/m2) cyclophosphamide (HD CY). For comparison of efficacy of each protocol, collected CD34+ cells over 4 × 106/kg and under 2 × 106/kg were defined as “adequate harvest” and “harvest failure,” respectively. Results: The median number of collected CD34+ cells was 5.58 × 106/kg in patients receiving single-dose etoposide, and the percentage of uncomplicated optimal harvest of E375 (65.6%, 21/32) was significantly higher than that of E750 (41.9%, 13/31) and HD CY (31.3%, 15/48). The E375 showed the highest rate of adequate harvest (96.9%, 31/32) compared to that of E750 (87.1%), HD CY (75.0%), and G-mobilization (59.6%). Most E375 patients achieved adequate harvest without complication (29/32, 90.6%), the CD34+ cell collection yield on apheresis days one and two of E375 was not significantly different from that of E750, and no harvest failures occurred for E375. Neutrophil and platelet engraftments were significantly faster in E375 than other groups (P <.001). Conclusions: The use of single-dose etoposide could be an effective and safe method for mobilization in patients with MM.",

keywords = "autologous stem cell transplantation, etoposide, mobilization, multiple myeloma",

author = "Yong Park and Kim, {Dae Sik} and Jeon, {Min Ji} and Lee, {Byung Hyun} and Yu, {Eun Sang} and Kang, {Ka Won} and Lee, {Se Ryeon} and Sung, {Hwa Jung} and Myung-Hyun Nam and Soo-Young Yoon and Choi, {Chul Won} and Kang, {Eun Suk} and Duck Cho and Kihyun Kim and Kim, {Byung Soo} and Kim, {Dae Won} and Kim, {Seok Jin}",

note = "Funding Information: This study was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science, and Technology (NRF-2017R1A2B4005136). Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",

year = "2019",

month = oct,

day = "1",

doi = "10.1002/jca.21734",

language = "English",

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pages = "579--588",

journal = "Journal of Clinical Apheresis",

issn = "0733-2459",

publisher = "Wiley-Liss Inc.",

number = "5",

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TY - JOUR

T1 - Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma

AU - Park, Yong

AU - Kim, Dae Sik

AU - Jeon, Min Ji

AU - Lee, Byung Hyun

AU - Yu, Eun Sang

AU - Kang, Ka Won

AU - Lee, Se Ryeon

AU - Sung, Hwa Jung

AU - Nam, Myung-Hyun

AU - Yoon, Soo-Young

AU - Choi, Chul Won

AU - Kang, Eun Suk

AU - Cho, Duck

AU - Kim, Kihyun

AU - Kim, Byung Soo

AU - Kim, Dae Won

AU - Kim, Seok Jin

N1 - Funding Information: This study was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education, Science, and Technology (NRF-2017R1A2B4005136). Publisher Copyright: © 2019 Wiley Periodicals, Inc.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: Single-dose etoposide was used an outpatient-based protocol for mobilization in patients with multiple myeloma (MM) for autologous stem cell transplantation (ASCT). Thus, we retrospectively analyzed the efficacy and safety of our one-day protocol in comparison with that of previous methods. Methods: We retrospectively analyzed 168 patients with MM who underwent peripheral blood stem cell collection for upfront ASCT between 2008 and 2018. The mobilization protocols included G-CSF alone (G-mobilization), one-day 375 mg/m2 of etoposide (E375), two-days of 375 mg/m2 of etoposide (E750), or one-day high-dose (3.5 g/m2) cyclophosphamide (HD CY). For comparison of efficacy of each protocol, collected CD34+ cells over 4 × 106/kg and under 2 × 106/kg were defined as “adequate harvest” and “harvest failure,” respectively. Results: The median number of collected CD34+ cells was 5.58 × 106/kg in patients receiving single-dose etoposide, and the percentage of uncomplicated optimal harvest of E375 (65.6%, 21/32) was significantly higher than that of E750 (41.9%, 13/31) and HD CY (31.3%, 15/48). The E375 showed the highest rate of adequate harvest (96.9%, 31/32) compared to that of E750 (87.1%), HD CY (75.0%), and G-mobilization (59.6%). Most E375 patients achieved adequate harvest without complication (29/32, 90.6%), the CD34+ cell collection yield on apheresis days one and two of E375 was not significantly different from that of E750, and no harvest failures occurred for E375. Neutrophil and platelet engraftments were significantly faster in E375 than other groups (P <.001). Conclusions: The use of single-dose etoposide could be an effective and safe method for mobilization in patients with MM.

AB - Background: Single-dose etoposide was used an outpatient-based protocol for mobilization in patients with multiple myeloma (MM) for autologous stem cell transplantation (ASCT). Thus, we retrospectively analyzed the efficacy and safety of our one-day protocol in comparison with that of previous methods. Methods: We retrospectively analyzed 168 patients with MM who underwent peripheral blood stem cell collection for upfront ASCT between 2008 and 2018. The mobilization protocols included G-CSF alone (G-mobilization), one-day 375 mg/m2 of etoposide (E375), two-days of 375 mg/m2 of etoposide (E750), or one-day high-dose (3.5 g/m2) cyclophosphamide (HD CY). For comparison of efficacy of each protocol, collected CD34+ cells over 4 × 106/kg and under 2 × 106/kg were defined as “adequate harvest” and “harvest failure,” respectively. Results: The median number of collected CD34+ cells was 5.58 × 106/kg in patients receiving single-dose etoposide, and the percentage of uncomplicated optimal harvest of E375 (65.6%, 21/32) was significantly higher than that of E750 (41.9%, 13/31) and HD CY (31.3%, 15/48). The E375 showed the highest rate of adequate harvest (96.9%, 31/32) compared to that of E750 (87.1%), HD CY (75.0%), and G-mobilization (59.6%). Most E375 patients achieved adequate harvest without complication (29/32, 90.6%), the CD34+ cell collection yield on apheresis days one and two of E375 was not significantly different from that of E750, and no harvest failures occurred for E375. Neutrophil and platelet engraftments were significantly faster in E375 than other groups (P <.001). Conclusions: The use of single-dose etoposide could be an effective and safe method for mobilization in patients with MM.

KW - autologous stem cell transplantation

KW - etoposide

KW - mobilization

KW - multiple myeloma

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U2 - 10.1002/jca.21734

DO - 10.1002/jca.21734

M3 - Article

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AN - SCOPUS:85068660519

SN - 0733-2459

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EP - 588

JO - Journal of Clinical Apheresis

JF - Journal of Clinical Apheresis

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ER -

Single-dose etoposide is an effective and safe protocol for stem cell mobilization in patients with multiple myeloma

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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