Effectiveness and Safety of Low-Dose Etoposide Chemomobilization in Patients with Multiple Myeloma and Lymphoma

Filiz Mercan Sarıdaş; Vildan Ozkocaman; Fahir Özkalemkaş

Makale detayları

Effectiveness and Safety of Low-Dose Etoposide Chemomobilization in Patients with Multiple Myeloma and Lymphoma

Yazarlar:

Filiz Mercan Sarıdaş | Vildan Ozkocaman | Fahir Özkalemkaş

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 3, pp.367-373

Belge Tipi:

Makale

Yayın Tarihi:

12/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001338892

pISSN:

1300-414X

Anahtar kelimeler:

Özet:

 Studies have discovered a risk of treatment-related leukemia and myelodysplastic syndromes with high doses of etoposide prompting a closer look, at the effectiveness of lower doses. In this study, we aimed to demonstrate the efficacy of low-dose etoposide in patients with MM and lymphoma. Forty-eight patients with MM and refractory lymphoma who underwent stem cell mobilization with low-dose etoposide days 1 and 2, 375 mgm² and granulocyte colony-stimulating factor G-CSF, 10-15 μgkg after the 3rd day in Bursa Uludağ University Faculty of Medicine Hematology Department Stem Cell Transplantation Unit were analyzed retrospectively. The rate of successful mobilization  2x106kg CD34 cell collection was 95 and was performed in a minimum of 1 and a maximum of 3 apheresis. The median collected CD34 cell count was 9.165  10⁶kg 11.7 in good vs 3.98 in poor mobilizers, p0.001. It was determined that a low number of peripheral CD34 cells on the first day Hazard ratio HR; 0.00, 95 Confidence interval CI 0.00-0.660; p0.040 and prior autologous hematopoietic stem cell transplantation HR; 1.206, 95 CI 1.009-1.442; p0.043 were independent risk factors for poor mobilization. Febrile neutropenia occurred in 18.8 11.4 in good vs 38.5 in poor mobilizers, p0.048, and 16.7 required erythrocyte transfusions 14.3 in good vs 23.1 in poor mobilizers, p0.664. In the median follow-up of 35.5 months, no treatment-related secondary malignancy was detected in any patients. Our results show that low-dose etoposide and G-CSF are effective mobilization agents with tolerable toxicity in patients with MM and refractory lymphoma.

 Studies have discovered a risk of treatment-related leukemia and myelodysplastic syndromes with high doses of etoposide prompting a closer look, at the effectiveness of lower doses. In this study, we aimed to demonstrate the efficacy of low-dose etoposide in patients with MM and lymphoma. Forty-eight patients with MM and refractory lymphoma who underwent stem cell mobilization with low-dose etoposide days 1 and 2, 375 mgm² and granulocyte colony-stimulating factor G-CSF, 10-15 μgkg after the 3rd day in Bursa Uludağ University Faculty of Medicine Hematology Department Stem Cell Transplantation Unit were analyzed retrospectively. The rate of successful mobilization  2x106kg CD34 cell collection was 95 and was performed in a minimum of 1 and a maximum of 3 apheresis. The median collected CD34 cell count was 9.165  10⁶kg 11.7 in good vs 3.98 in poor mobilizers, p0.001. It was determined that a low number of peripheral CD34 cells on the first day Hazard ratio HR; 0.00, 95 Confidence interval CI 0.00-0.660; p0.040 and prior autologous hematopoietic stem cell transplantation HR; 1.206, 95 CI 1.009-1.442; p0.043 were independent risk factors for poor mobilization. Febrile neutropenia occurred in 18.8 11.4 in good vs 38.5 in poor mobilizers, p0.048, and 16.7 required erythrocyte transfusions 14.3 in good vs 23.1 in poor mobilizers, p0.664. In the median follow-up of 35.5 months, no treatment-related secondary malignancy was detected in any patients. Our results show that low-dose etoposide and G-CSF are effective mobilization agents with tolerable toxicity in patients with MM and refractory lymphoma.

 Studies have discovered a risk of treatment-related leukemia and myelodysplastic syndromes with high doses of etoposide prompting a closer look, at the effectiveness of lower doses. In this study, we aimed to demonstrate the efficacy of low-dose etoposide in patients with MM and lymphoma. Forty-eight patients with MM and refractory lymphoma who underwent stem cell mobilization with low-dose etoposide days 1 and 2, 375 mgm² and granulocyte colony-stimulating factor G-CSF, 10-15 μgkg after the 3rd day in Bursa Uludağ University Faculty of Medicine Hematology Department Stem Cell Transplantation Unit were analyzed retrospectively. The rate of successful mobilization  2x106kg CD34 cell collection was 95 and was performed in a minimum of 1 and a maximum of 3 apheresis. The median collected CD34 cell count was 9.165  10⁶kg 11.7 in good vs 3.98 in poor mobilizers, p0.001. It was determined that a low number of peripheral CD34 cells on the first day Hazard ratio HR; 0.00, 95 Confidence interval CI 0.00-0.660; p0.040 and prior autologous hematopoietic stem cell transplantation HR; 1.206, 95 CI 1.009-1.442; p0.043 were independent risk factors for poor mobilization. Febrile neutropenia occurred in 18.8 11.4 in good vs 38.5 in poor mobilizers, p0.048, and 16.7 required erythrocyte transfusions 14.3 in good vs 23.1 in poor mobilizers, p0.664. In the median follow-up of 35.5 months, no treatment-related secondary malignancy was detected in any patients. Our results show that low-dose etoposide and G-CSF are effective mobilization agents with tolerable toxicity in patients with MM and refractory lymphoma.

 Çalışmalarda yüksek doz etoposid ile tedaviye bağlı lösemi ve miyelodisplastik sendrom riskinin keşfedilmesi, daha düşük dozların etkinliğine daha yakından bakılmasına neden olmuştur. Bu çalışmada, multiple miyelom MM ve lenfoma hastalarında düşük doz etoposidin etkinliğini göstermeyi amaçladık. Bursa Uludağ Üniversitesi Tıp Fakültesi Hematoloji Bölümü Kök Hücre Nakli Ünitesinde düşük doz etoposid 1. ve 2. günler, 375 mgm² ve granulocyte colony-stimulating factor G-CSF, 3. günden sonra 10-15 μgkg ile kök hücre mobilizasyonu yapılan MM ve refrakter lenfomalı 48 hasta retrospektif olarak analiz edildi. Başarılı mobilizasyon  2x106kg CD34 hücre toplanması oranı 95 olup en az 1, en fazla 3 aferezde gerçekleştirildi. Toplanan median CD34 hücre sayısı 9,165  10⁶kg idi good mobilizerlerde 11,7 vs poor mobilizerde 3,98 10⁶kg, p0,001. İlk gün periferik CD34 hücre sayısının düşük olmasının Hazard ratio HR; 0.00, 95 confidence interval CI 0.00-0.660; p0,040 ve önceki otolog hematopoietik kök hücre naklinin HR; 1.206, 95 CI 1.009-1.442; p0,043 kötü mobilizasyon için bağımsız risk faktörleri olduğu belirlendi. Hastaların 18,8inde febril nötropeni saptandı good mobilizerlerde 11,4 vs poor mobilizerlerde 38,5, p0,048 ve 16,7sinde eritrosit transfüzyonu ihtiyacı oldu good mobilizerlerde 14,3 vs poor mobilizerlerde 23,1, p0,664. Median 35,5 aylık takip süresinde hastaların hiçbirinde tedaviye bağlı ikincil malignite saptanmadı. Çalışmamızın sonuçları düşük doz etoposid ve G-CSFnin MM ve refrakter lenfoma hastalarında tolere edilebilir toksisite ile etkili mobilizasyon ajanları olduğunu ortaya koydu.

Makale detayları

Effectiveness and Safety of Low-Dose Etoposide Chemomobilization in Patients with Multiple Myeloma and Lymphoma

Yazarlar:

Filiz Mercan Sarıdaş | Vildan Ozkocaman | Fahir Özkalemkaş

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 3, pp.367-373

Belge Tipi:

Makale

Yayın Tarihi:

12/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001338892

pISSN:

1300-414X

low-dose etoposide

stem cell mobilization

multiple myeloma

lymphoma

autologous hematopoietic stem cell transplantationdüşük doz etoposid

kök hücre mobilizasyonu

multiple miyelom

lenfoma

otolog hematopoetik kök hücre transplantasyonu

Sayı

Makale detayları

Yazarlar: Filiz Mercan Sarıdaş | Vildan Ozkocaman | Fahir Özkalemkaş

Yayıncı: Bursa Uludağ University

Ana Başlıklar: Hematoloji | İç Hastalıkları

Dergi: Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 3, pp.367-373

Belge Tipi: Makale

Yayın Tarihi: 12/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001338892

pISSN: 1300-414X

Sayı

Yazarlar:

Filiz Mercan Sarıdaş | Vildan Ozkocaman | Fahir Özkalemkaş

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Hematoloji | İç Hastalıkları

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 3, pp.367-373

Belge Tipi:

Makale

Yayın Tarihi:

12/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001338892

pISSN:

1300-414X