Header

UZH-Logo

Maintenance Infos

Mobilization of hematopoietic progenitor cells with standard or reduced dose filgrastim after vinorelbine in multiple myeloma patients. a randomized prospective single center phase II study


Samaras, Panagiotis; Rütti, Markus F; Seifert, Burkhardt; Bachmann, Helga; Schanz, Urs; Eisenring, Maya; Renner, Christoph; Müller, Antonia Maria; Schmidt, Adrian; Mischo, Axel; Fuchs, Ivo; Bargetzi, Mario; Manz, Markus G; Stupp, Roger; Petrausch, Ulf; Stenner-Liewen, Frank (2018). Mobilization of hematopoietic progenitor cells with standard or reduced dose filgrastim after vinorelbine in multiple myeloma patients. a randomized prospective single center phase II study. Biology of Blood and Marrow Transplantation, 24(4):694-699.

Abstract

Vinorelbine combined with filgrastim (r-metHuG-CSF) at a dose of 10 µg/kg of body weight (BW) per day is a reliable and well tolerated regimen for mobilization of hematopoietic progenitor cells (HPC) in patients with multiple myeloma. This prospective randomized phase 2 study was initiated to assess the feasibility of a reduced filgrastim dosage. Vinorelbine was combined with either standard dosed filgrastim (10 µg/kg body weight (BW) per day) or reduced dosed filgrastim (5 µg/kg BW per day). Leukapheresis sessions were planned to start at day 8 and were continued until the predefined target amount of 4 x 106 HPC/kg BW was collected. The study demonstrated the feasibility of vinorelbine combined with reduced daily filgrastim with a mean of 1.29 leukapheresis sessions necessary per patient (95% confidence interval 0.95-1.7). All patients could start leukapheresis as planned at day 8, and the collection success rate was 100% for the whole patient collective after a maximum of two leukapheresis sessions. No statistically significant differences with regard to the amount of HPC collected between the two groups were observed (p=0.99). Accordingly, no differences were seen with regard to length of hospitalization for autotransplant (p=0.34), duration of neutrophil (p=0.93) and platelet engraftment (p=0.42). Patients receiving reduced dose filgrastim reported significantly lower peak pain values in a numerical analogue scale (p=0.01), and the costs were significantly lower than in the patients undergoing standard dosed chemo-mobilization (p=0.001). Vinorelbine 35 mg/m2 plus filgrastim 5 µg /kg BW once per day until completion of HPC collection is feasible and appears to be advantageous with respect to the severity of pain intensity and treatment costs.

Abstract

Vinorelbine combined with filgrastim (r-metHuG-CSF) at a dose of 10 µg/kg of body weight (BW) per day is a reliable and well tolerated regimen for mobilization of hematopoietic progenitor cells (HPC) in patients with multiple myeloma. This prospective randomized phase 2 study was initiated to assess the feasibility of a reduced filgrastim dosage. Vinorelbine was combined with either standard dosed filgrastim (10 µg/kg body weight (BW) per day) or reduced dosed filgrastim (5 µg/kg BW per day). Leukapheresis sessions were planned to start at day 8 and were continued until the predefined target amount of 4 x 106 HPC/kg BW was collected. The study demonstrated the feasibility of vinorelbine combined with reduced daily filgrastim with a mean of 1.29 leukapheresis sessions necessary per patient (95% confidence interval 0.95-1.7). All patients could start leukapheresis as planned at day 8, and the collection success rate was 100% for the whole patient collective after a maximum of two leukapheresis sessions. No statistically significant differences with regard to the amount of HPC collected between the two groups were observed (p=0.99). Accordingly, no differences were seen with regard to length of hospitalization for autotransplant (p=0.34), duration of neutrophil (p=0.93) and platelet engraftment (p=0.42). Patients receiving reduced dose filgrastim reported significantly lower peak pain values in a numerical analogue scale (p=0.01), and the costs were significantly lower than in the patients undergoing standard dosed chemo-mobilization (p=0.001). Vinorelbine 35 mg/m2 plus filgrastim 5 µg /kg BW once per day until completion of HPC collection is feasible and appears to be advantageous with respect to the severity of pain intensity and treatment costs.

Statistics

Citations

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Hematology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Immunology
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Clinic for Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2018
Deposited On:08 Jan 2018 20:18
Last Modified:13 Apr 2018 01:02
Publisher:Elsevier
ISSN:1083-8791
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.bbmt.2017.12.775
PubMed ID:29246820

Download

Full text not available from this repository.
View at publisher

Get full-text in a library