[Comparison of Plerixafor or Cyclophosphamide Combined with G-CSF in Mobilization of Peripheral Blood Stem Cells in Multiple Myeloma].

Objective: To compare the efficacy of plerixafor (PXF) combined with granulocyte colony-stimulating factor (G-CSF) (PXF+G-CSF) and cyclophosphamide (Cy) combined with G-CSF (Cy+G-CSF) in the mobilization of peripheral blood stem cells (PBSCs) in patients with multiple myeloma (MM).

Methods: The clinical data of 41 MM patients who underwent PBSC mobilization using PXF+G-CSF (18 cases) or Cy+G-CSF (23 cases) in Shanxi Bethune Hospital from January 2019 to December 2021 were retrospectively analyzed, including the count of collected CD34 cells, acquisition success rate, failure rate, and optimal rate. The correlation of sex, age, disease type, DS staging, ISS staging, number of chemotherapy cycle, disease status before mobilization, and mobilization regimen with the collection results was analyzed, and the adverse reactions, length of hospital stay, and hospitalization costs were compared between the two mobilization regimens.

Results: The 41 patients underwent 97 mobilization collections, and the median number of CD34 cells collected was 6.09 (0-34.07)×10/kg. The acquisition success rate, optimal rate, and failure rate was 90.2%, 56.1%, and 9.8%, respectively. Univariate analysis showed that sex, age, disease type, and disease stage had no significant correlation with the number of CD34 cells collected and acquisition success rate ( >0.05), but the patients with better disease remission than partial remission before mobilization were more likely to obtain higher CD34 cell count ( <0.05). The PXF+G-CSF group had a larger number of CD34 cells and higher acquisition success rate in the first collection than Cy+G-CSF group (both <0.05), and had lower infection risk and shorter length of hospital stay during mobilization (both <0.05), but the economic burden increased ( <0.05).

Conclusion: PXF+G-CSF used for PBSC mobilization in MM patients has high first acquisition success rate, large number of CD34 cells, less number of collection times, and short length of hospital stay, but the economic cost is heavy.