PMID- 33911199
OWN - NLM
STAT- MEDLINE
DCOM- 20211013
LR  - 20230203
IS  - 1476-5365 (Electronic)
IS  - 0268-3369 (Linking)
VI  - 56
IP  - 9
DP  - 2021 Sep
TI  - The association of mobilising regimen on immune reconstitution and survival in 
      myeloma patients treated with bortezomib, cyclophosphamide and dexamethasone 
      induction followed by a melphalan autograft.
PG  - 2152-2159
LID - 10.1038/s41409-021-01300-2 [doi]
AB  - G-CSF only mobilisation has been shown to enhance immune reconstitution early 
      post-transplant, but its impact on survival remains uncertain. We undertook a 
      retrospective review of 12 transplant centres to examine overall survival (OS) 
      and time to next treatment (TTNT) following melphalan autograft according to 
      mobilisation method (G-CSF only vs. G-CSF and cyclophosphamide [CY]) in myeloma 
      patients uniformly treated with bortezomib, cyclophosphamide and dexamethasone 
      induction. Six centres had a policy to use G-CSF alone and six to use G-CSF + CY. 
      Patients failing G-CSF only mobilisation were excluded. 601 patients were 
      included: 328: G-CSF + CY, 273: G-CSF only. Mobilisation arms were comparable in 
      terms of age, Revised International Staging System (R-ISS) groups and 
      post-transplant maintenance therapy. G-CSF + CY mobilisation generated higher 
      median CD34 + yields (8.6 vs. 5.5 x 10(6)/kg, p < 0.001). G-CSF only mobilisation 
      was associated with a significantly higher lymphocyte count at day 15 
      post-infusion (p < 0.001). G-CSF only mobilisation was associated with 
      significantly improved OS (aHR = 0.60, 95%CI 0.39-0.92, p = 0.018) and TTNT 
      (aHR = 0.77, 95%CI 0.60-0.97, p = 0.027), when adjusting for R-ISS, 
      disease-response pre-transplant, age and post-transplant maintenance therapy. 
      This survival benefit may reflect selection bias in excluding patients with 
      unsuccessful G-CSF only mobilisation or may be due to enhanced autograft immune 
      cell content and improved early immune reconstitution.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer Nature Limited.
FAU - Rees, Matthew J
AU  - Rees MJ
AUID- ORCID: 0000-0001-8360-2952
AD  - Department of Clinical Haematology, Austin Health, Melbourne, VIC, Australia. 
      Matthew.Rees@austin.org.au.
FAU - Mollee, Peter
AU  - Mollee P
AD  - Department of Haematology, Princess Alexandra Hospital, and School of Medicine, 
      University of Queensland, Brisbane, QLD, Australia.
FAU - Ng, Jun Yen
AU  - Ng JY
AD  - Department of Haematology, Princess Alexandra Hospital, and School of Medicine, 
      University of Queensland, Brisbane, QLD, Australia.
FAU - Murton, Alex
AU  - Murton A
AD  - Department of Haematology, Royal Hobart Hospital, Hobart, TAS, Australia.
FAU - Gonsalves, Jose Filipe
AU  - Gonsalves JF
AD  - Department of Haematology, St Vincent's Hospital, Melbourne, VIC, Australia.
FAU - Panigrahi, Ashish
AU  - Panigrahi A
AD  - Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, VIC, 
      Australia.
FAU - Beer, Hayley
AU  - Beer H
AD  - Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, VIC, 
      Australia.
FAU - Loh, Joanna
AU  - Loh J
AD  - Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash 
      University, Melbourne, VIC, Australia.
FAU - Nguyen, Philip
AU  - Nguyen P
AD  - Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash 
      University, Melbourne, VIC, Australia.
FAU - Hunt, Sam
AU  - Hunt S
AD  - Department of Haematology, Eastern Health, Melbourne, VIC, Australia.
FAU - Jina, Hayden
AU  - Jina H
AD  - Department of Haematology, Eastern Health, Melbourne, VIC, Australia.
FAU - Wayte, Rebecca
AU  - Wayte R
AD  - Department of Clinical Haematology, Westmead Hospital, Sydney, NSW, Australia.
FAU - Sutrave, Gaurav
AU  - Sutrave G
AD  - Department of Clinical Haematology, Westmead Hospital, Sydney, NSW, Australia.
FAU - Tan, Jocelyn
AU  - Tan J
AD  - Department of Haematology, University Hospital Geelong, Geelong, VIC, Australia.
FAU - Abeyakoon, Chathuri
AU  - Abeyakoon C
AD  - Department of Haematology, University Hospital Geelong, Geelong, VIC, Australia.
FAU - Chee, Ashlyn
AU  - Chee A
AD  - Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
FAU - Augustson, Bradley
AU  - Augustson B
AD  - Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
FAU - Kalro, Akash
AU  - Kalro A
AD  - Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia.
FAU - Lee, Cindy
AU  - Lee C
AD  - Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia.
FAU - Agrawal, Shivam
AU  - Agrawal S
AD  - Department of Haematology, Princes of Wales Hospital, Sydney, NSW, Australia.
FAU - Churilov, Leonid
AU  - Churilov L
AD  - Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
FAU - Chua, Chong Chyn
AU  - Chua CC
AD  - Department of Clinical Haematology, Austin Health, Melbourne, VIC, Australia.
FAU - Lim, Andrew Boon Ming
AU  - Lim ABM
AD  - Department of Clinical Haematology, Austin Health, Melbourne, VIC, Australia.
FAU - Zantomio, Daniela
AU  - Zantomio D
AD  - Department of Clinical Haematology, Austin Health, Melbourne, VIC, Australia.
FAU - Grigg, Andrew
AU  - Grigg A
AD  - Department of Clinical Haematology, Austin Health, Melbourne, VIC, Australia.
LA  - eng
PT  - Journal Article
DEP - 20210428
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - 69G8BD63PP (Bortezomib)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Autografts
MH  - Bortezomib/therapeutic use
MH  - Cyclophosphamide/therapeutic use
MH  - Dexamethasone/therapeutic use
MH  - Granulocyte Colony-Stimulating Factor/therapeutic use
MH  - Hematopoietic Stem Cell Mobilization
MH  - Humans
MH  - *Immune Reconstitution
MH  - Melphalan/therapeutic use
MH  - *Multiple Myeloma/drug therapy
MH  - Retrospective Studies
EDAT- 2021/04/30 06:00
MHDA- 2021/10/14 06:00
CRDT- 2021/04/29 06:15
PHST- 2021/02/10 00:00 [received]
PHST- 2021/04/08 00:00 [accepted]
PHST- 2021/03/24 00:00 [revised]
PHST- 2021/04/30 06:00 [pubmed]
PHST- 2021/10/14 06:00 [medline]
PHST- 2021/04/29 06:15 [entrez]
AID - 10.1038/s41409-021-01300-2 [pii]
AID - 10.1038/s41409-021-01300-2 [doi]
PST - ppublish
SO  - Bone Marrow Transplant. 2021 Sep;56(9):2152-2159. doi: 
      10.1038/s41409-021-01300-2. Epub 2021 Apr 28.