Vinorelbine-Cyclophosphamide compared to Cyclophosphamide in Peripheral Blood Stem Cell Mobilization for Multiple Myeloma

Publication date: Available online 23 April 2018
Source:Hematology/Oncology and Stem Cell Therapy
Author(s): Sanjay de Mel, Yunxin Chen, Adeline Lin, Teck Guan Soh, Melissa Ooi, Eng Soo Yap, Lara Kristina Sioco Donato, Nurul Aidah Abdul Halim, Joanna Mah, Karen Lim, Li Mei Poon, Belinda Tan, Yelly, Hui Li Lim, Liang Piu Koh, Bee Choo Tai, Zhaojin Chen, Wee Joo Chng, Satish Kumar Gopalakrishnan, Lip Kun Tan
BackgroundHigh dose Cyclophosphamide (Cy) and Vinorelbine Cyclophosphamide (Vino-Cy) are stem cell (SC) mobilisation options for patients with multiple myeloma (MM). We present a comparison of mobilisation outcomes using these regimens.Patients and MethodsVino-Cy patients received Vinorelbine 25mg/m² on day 1, cyclophosphamide 1500mg/m² on day 2, and pegylated GCSF on day 4 or GCSF 10mcg/kg/day from day 4 onwards. Cy patients were given cyclophosphamide 4000mg/m² on day 1 and GCSF10mcg/kg/day from day 5 onwards. The target CD34+SC collection was 5 x 10⁶per kg/BW.Results149 patients were included. SC collection was lower in the Vino-Cy group (8.20 x 10 ⁶ /Kg BW) compared to the Cy group (11.43 x 10 ⁶/Kg BW), with adjusted geometric mean ratio of 0.59 (95% CI 0.41 to 0.86, p = 0.006). Time taken to achieve an adequate PB SC count was shorter for Vino-Cy (9 ± 1 day compared to 12 ± 2 days for Cy, adjusted absolute mean difference -3.95, 95% CI -4.85 to -3.06, P < .001). Mobilisation related toxicities (in particular, neutropaenic fever) were greater for Cy.ConclusionVino-Cy is a potential alternative to Cy given the need for effective mobilisation protocols with acceptable toxicity.



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