SCT without growth factor in multiple myeloma: engraftment kinetics, bacteremia and hospitalization

Gertz, M A; Gastineau, Dennis A.; Lacy, Martha Q.; Dispenzieri, Angela; Hayman, S. R.; Kumar, Shaji; Dingli, David; Leung, Nelson; Wolf, Robert C.; Hogan, W. J.; Buadi, Francis K.

doi:10.1038/bmt.2010.233

Cited by 16 publications

(29 citation statements)

References 26 publications

(27 reference statements)

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“…However, the neutrophil engraftment kinetics was similar regardless of the use of G-CSF. No advantage in terms of OS and PFS was noted, as mentioned [39]. …”

Section: Discussionmentioning

confidence: 95%

Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma

2012

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BackgroundMultiple Myeloma (MM) is the commonest indication for autologous stem cell transplantation (ASCT).MethodsWe retrospectively analysed data from 85 patients with MM submitted to ASCT in our centre from 2000 to 2010: 132 ASCT were realized, 80 of them as tandem.ResultsAfter induction, 17.6% were in complete remission (CR), 41.2% in very good partial remission (VGPR) and 41.2% in partial remission (PR). After transplant 44.7% were in CR, 15.3% in VGPR and 40% in PR. With 22 months (range – 3 to 117 months) of median follow-up, median overall survival (OS) was 43 months and progression-free survival (PFS) 22 months. At 5 years, OS was 45.3% (36.7-53.9%, 95%) and PFS 24.5% (18-31%, 95%). Patients with CR after ASCT had significantly longer PFS as compared to patients with PR (27 vs 7 months; p = 0.034) but not when compared to patients with VGPR (27 vs 19 months, p = 0.485). The tandem approach represented an advantage in OS and PFS when compared to only one ASCT (31 vs 19 months - p = 0.018, and 40 vs 31 - p = 0.04, respectively).ConclusionsOur results highlight the impact of response to transplant in patients PFS and tandem modality showed to carry better PFS and OS then the single transplant.

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“…However, the neutrophil engraftment kinetics was similar regardless of the use of G-CSF. No advantage in terms of OS and PFS was noted, as mentioned [39]. …”

Section: Discussionmentioning

confidence: 95%

Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma

2012

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“…We did not perform a pharmacoeconomical analysis, but it is very likely that the cost of the at-home ASCT was also reduced, as has been suggested in previous studies. 8,15 In conclusion, the use of G-CSF in at-home ASCT for patients with MM is not required.…”

Section: ) Nsmentioning

confidence: 99%

“…2 In this study, both the lower febrile neutropenia and the successful control of fever at home resulted in an overall readmission rate significantly lower than that observed in previous outpatient ASCT series (11% vs 50-70%, respectively). 3,8 Prior studies have reported that the use of G-CSF after ASCT accelerates neutrophil recovery by 2-9 days. 6 We have also reproduced these data; however, we did not observe any differences in the incidence and duration of febrile neutropenia, in the incidence of serious infections requiring hospital readmission or in the duration of IV antibiotic therapy, as other authors have found.…”

Section: ) Nsmentioning

confidence: 99%

“…6 We have also reproduced these data; however, we did not observe any differences in the incidence and duration of febrile neutropenia, in the incidence of serious infections requiring hospital readmission or in the duration of IV antibiotic therapy, as other authors have found. 7,8 Oral and intestinal mucositis is a very common and debilitating adverse event. It has a negative impact on patients' quality of life and it can lead to dehydration, malnutrition and serious infections, all of which have a particularly negative impact on at-home ASCT.…”

Section: ) Nsmentioning

confidence: 99%

“…4 However, it has been reported that G-CSF administration after ASCT does not reduce the incidence or duration of febrile neutropenia or the infectious mortality rate. [5][6][7][8] Moreover, G-CSF administration has been associated with a higher incidence of clinical complications such as engraftment syndrome (ES) and capillary leak syndrome. [9][10][11] For these reasons, its use after ASCT is controversial.…”

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confidence: 99%

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At-home autologous stem cell transplantation in multiple myeloma with and without G-CSF administration: a comparative study

Martínez-Cibrián

Magnano

Gutiérrez-García

et al. 2015

Bone Marrow Transplant

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A systematic literature review of the efficacy, effectiveness, and safety of filgrastim

Dale

Crawford

Klippel

et al. 2017

Support Care Cancer

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Purpose Filgrastim (NEUPOGEN ® ) is the originator recombinant human granulocyte colony-stimulating factor widely used for preventing neutropenia-related infections and mobilizing hematopoietic stem cells. This report presents findings of a systematic literature review and meta-analysis of efficacy and safety of originator filgrastim to update previous reports. Methods A literature search of electronic databases, congress abstracts, and bibliographies of recent reviews was conducted to identify English-language reports of clinical trials and observational studies evaluating filgrastim in its US-approved indications up to February 2015. Two independent reviewers assessed titles/abstracts and full texts of publications, and extracted data from studies that compared originator filgrastim vs placebo or no treatment. For outcomes with sufficient homogeneous data reported across studies, meta-analysis was performed and relative risk (RR) determined. Data were summarized descriptively for all other evaluated outcomes. Results A total of 1194 unique articles evaluating originator filgrastim were identified, with 25 meeting eligibility criteria for data extraction: 18 randomized controlled trials, 2 nonrandomized clinical trials, and 5 observational studies. In chemotherapy-induced neutropenia (CIN), filgrastim vs placebo or no treatment significantly reduced febrile neutropenia incidence (RR 0.63, 95% CI 0.53-0.75) and grade 3 or 4 neutropenia incidence (RR 0.50,. The most commonly reported adverse event (AE) with filgrastim was bone pain (RR 2.61, 95% CI 1.29-5.27 in CIN). Additional efficacy and safety outcomes are described within indications. Conclusions This systematic literature review and metaanalysis confirms and updates previous reports on the efficacy and safety of originator filgrastim. Bone pain was the commonly reported AE associated with filgrastim use.

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SCT without growth factor in multiple myeloma: engraftment kinetics, bacteremia and hospitalization

Cited by 16 publications

References 26 publications

Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma

Impact of tandem autologous stem cell transplantation and response to transplant in the outcome of multiple myeloma

At-home autologous stem cell transplantation in multiple myeloma with and without G-CSF administration: a comparative study

A systematic literature review of the efficacy, effectiveness, and safety of filgrastim

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