Comparative efficacy and safety of G-CSF alone versus G-CSF combined with different doses of cyclophosphamide for peripheral blood stem cell mobilization in patients with multiple myeloma
Transfusion and Apheresis Science, cilt.65, sa.4, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 65 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.transci.2026.104490
- Dergi Adı: Transfusion and Apheresis Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Hematopoietic stem cell mobilization, Granulocyte colony-stimulating factor, Cyclophosphamide, CD34-positive cells, Autologous stem cell transplantation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective Autologous hematopoietic stem cell transplantation (aHSCT) remains a standard treatment for eligible patients with multiple myeloma (MM), and successful mobilization of adequate CD34⁺ cells is critical. This study evaluated the efficacy and safety of G-CSF alone versus G-CSF combined with different doses of cyclophosphamide for peripheral blood stem cell mobilization. Methods In this retrospective, single-center study, 166 patients with MM undergoing first-time mobilization were analyzed. Patients were grouped as follows: G-CSF alone (Group 1), G-CSF plus cyclophosphamide 1–2 g/m² (Group 2), and G-CSF plus cyclophosphamide 3–4 g/m² (Group 3). Successful mobilization was defined as ≥ 2 × 10⁶ CD34⁺ cells/kg. Outcomes included mobilization success, CD34⁺ yield, apheresis requirements, and toxicity. Results Mobilization success rates were 60.6%, 84.8%, and 97.6% in Groups 1, 2, and 3, respectively (p < 0.001). CD34⁺ cell yield increased with higher cyclophosphamide doses, with the highest yield in Group 3 (p < 0.001). Multivariate analysis showed that cyclophosphamide significantly improved mobilization success (Group 2: OR 4.57, p = 0.007; Group 3: OR 21.94, p = 0.005). Fewer apheresis sessions were required in higher-dose groups. No significant differences were observed in febrile neutropenia or platelet transfusion rates. Conclusion Adding cyclophosphamide to G-CSF significantly improves mobilization success and CD34⁺ yield in MM patients. Higher cyclophosphamide doses provide superior efficacy without increased toxicity, supporting chemo-mobilization as an effective and safe strategy in selected patients.