Comparison of the efficiency, safety, and survival outcomes in two stem cell mobilization regimens with cyclophosphamide plus G-CSF or G-CSF alone in multiple myeloma: a meta-analysis.

Abstract	Autologous stem cell transplantation as a frontline treatment for patients with multiple myeloma (MM) requires an adequate peripheral blood stem cell (PBSC) collection before processing. Granulocyte-colony stimulating factor (G-CSF) with or without cyclophosphamide (CTX) is a common regimen for PBSC mobilization; their benefits and risks are controversial. To compare the efficiency, safety, and survival outcomes between the two regimens, we conducted a meta-analysis including 18 studies with 4 prospective and 14 retrospective studies; a total of 2770 patients with MM were analyzed. The CTX plus G-CSF regimen had higher yields of total CD34+ cells (SMD = 0.39, 95% CI (0.30, 0.49)), and higher mobilization rates of the target ⩾ 2 × 106/kg (OR = 3.34, 95% CI (1.82, 6.11)) and 4 × 106/kg (OR = 2.16, 95% CI (1.69, 2.76)) cells. A favorable event-free survival (EFS) (HR = 0.73, 95% CI (0.58, 0.93), p = 0.01) and better 3-year EFS rate (OR = 1.65, 95% CI (1.1, 2.47), p = 0.02) were also reached in the patients with CTX plus G-CSF mobilization, although the risks of admission (OR = 26.49, 95% CI (7.31, 95.97)) and fever (OR = 13.66, 95% CI (6.21, 30.03)) during mobilization were increased, the treatment-related mortality was consistent (p = 0.26). The CTX plus G-CSF regimen was superior to the G-CSF-alone regimen for PBSC mobilization in patients with MM.
Authors	Liwen Wang, Hongxian Xiang, Yuhan Yan, Zuqun Deng, Hui Li, Xin Li, Jing Liu
Journal	Annals of hematology (Ann Hematol) Vol. 100 Issue 2 Pg. 563-573 (Feb 2021) ISSN: 1432-0584 [Electronic] Germany
PMID	33404694 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Systematic Review)
Chemical References	Granulocyte Colony-Stimulating Factor Cyclophosphamide
Topics	Autografts Cyclophosphamide (adverse effects, therapeutic use) Disease-Free Survival Granulocyte Colony-Stimulating Factor (adverse effects, therapeutic use) Hematopoietic Stem Cell Mobilization Hematopoietic Stem Cell Transplantation Humans Multiple Myeloma (mortality, therapy) Safety Survival Rate

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