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

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?

Conclusion

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