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Comparison of the efficiency, safety and survival outcomes in two stem cells mobilization regimens with cyclophosphamide plus G-CSF or G-CSF alone in multiple myeloma: a meta-analysis
Jing Liu
Third Xiangya Hospital of Central South University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7366-5287
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Autologous stem cell transplantation as a frontline treatment for patients with multiple myeloma (MM), it requires an adequate peripheral blood stem cells (PBSC) collection before processing. Granulocyte-colony stimulating factor (G-CSF) with or without cyclophosphamide (CTX) are common regimens for PBSC mobilization, their benefits and risks are controversial.
Methods 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 analyzed.
Results 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 ⩾ 2x106/kg (OR = 3.34, 95% CI (1.82, 6.11)) and 4x106/kg (OR = 2.16, 95% CI (1.69, 2.76)) cells. A favorable 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 were consistent (p = 0.26).
Conclusions The CTX plus G-CSF regimen was superior to the G-CSF-alone regimen for PBSC mobilization in patients with MM.
Keywords
Multiple myeloma, Cyclophosphamide, Granulocyte-colony stimulating factor, Stem cells mobilization, Event-free survival.
Figure 1
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This is a list of supplementary files associated with this preprint. Click to download.
- Supplementaryfile1.docx
- Supplementaryfile2.docx
- Sup.Table1.CharacteristicsofPatientsUnderwentASCT.docx
- Sup.Table2.SummaryResultsofSensitiveAnalysis.docx
- S.Fig.1Subgroupanalysis.jpg
- S.Fig.2Forestforothernonsurvivaldata.jpg
- S.Fig.3Forestforothersurvivaldata.jpg
- S.Fig.4Sensitiveanalysisofnonsurvivaldata.jpg
- S.Fig.5Sensitiveanalysisofsurvivaldata.jpg
- S.Fig.6Funnelplotsforpublicationbias.jpg
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Research
Comparison of the efficiency, safety and survival outcomes in two stem cells mobilization regimens with cyclophosphamide plus G-CSF or G-CSF alone in multiple myeloma: a meta-analysis
Jing Liu
Third Xiangya Hospital of Central South University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7366-5287
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 22 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Stem Cell & Developmental Cell Biology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Autologous stem cell transplantation as a frontline treatment for patients with multiple myeloma (MM), it requires an adequate peripheral blood stem cells (PBSC) collection before processing. Granulocyte-colony stimulating factor (G-CSF) with or without cyclophosphamide (CTX) are common regimens for PBSC mobilization, their benefits and risks are controversial.
Methods 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 analyzed.
Results 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 ⩾ 2x106/kg (OR = 3.34, 95% CI (1.82, 6.11)) and 4x106/kg (OR = 2.16, 95% CI (1.69, 2.76)) cells. A favorable 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 were consistent (p = 0.26).
Conclusions The CTX plus G-CSF regimen was superior to the G-CSF-alone regimen for PBSC mobilization in patients with MM.
Figure 1
Figure 2
Figure 3
Figure 4