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Clinical Trial
. 2018 Dec;11(4):225-232.
doi: 10.1016/j.hemonc.2018.04.001. Epub 2018 Apr 23.

Vinorelbine-Cyclophosphamide compared to cyclophosphamide in peripheral blood stem cell mobilization for multiple myeloma

Sanjay de Mel  1 , Yunxin Chen  2 , Adeline Lin  3 , Teck Guan Soh  4 , Melissa Ooi  3 , Eng Soo Yap  3 , Lara Kristina Sioco Donato  2 , Nurul Aidah Abdul Halim  2 , Joanna Mah  4 , Karen Lim  4 , Li Mei Poon  3 , Belinda Tan  3 , Yelly  3 , Hui Li Lim  3 , Liang Piu Koh  3 , Bee Choo Tai  5 , Zhaojin Chen  6 , Wee Joo Chng  3 , Satish Kumar Gopalakrishnan  2 , Lip Kun Tan  7
Affiliations
Free article
Clinical Trial

Vinorelbine-Cyclophosphamide compared to cyclophosphamide in peripheral blood stem cell mobilization for multiple myeloma

Sanjay de Mel et al. Hematol Oncol Stem Cell Ther. 2018 Dec.
Free article

Abstract

Background: High 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 methods: Vino-Cy patients received Vinorelbine 25 mg/m2 on day 1, cyclophosphamide 1500 mg/m2 on day 2, and pegylated GCSF on day 4 or GCSF 10 mcg/kg/day from day 4 onwards. Cy patients were given cyclophosphamide 4000 mg/m2 on day 1 and GCSF10 mcg/kg/day from day 5 onwards. The target CD34 + SC collection was 5 × 106 per kg/BW.

Results: 149 patients were included. SC collection was lower in the Vino-Cy group (8.20 × 106/Kg BW) compared to the Cy group (11.43 × 106/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.

Conclusion: Vino-Cy is a potential alternative to Cy given the need for effective mobilisation protocols with acceptable toxicity.

Keywords: Autologous transplantation; Chemotherapy; Stem cells.

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