A comparison of cyclophosphamide at different dose levels for stem cell mobilization in multiple myeloma.

Transfus Apher Sci

University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, Ankara, Türkiye; Ankara Yildirim Beyazit University, School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Türkiye.

Published: August 2025


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Article Abstract

Background: We conducted a multi-center retrospective non-randomized study to clarify roles of 2 and 3 gr/m doses of Cyclophosphamide (Cy) for stem cell mobilization in Multiple Myeloma.

Material And Methods: This study analyzed 169 adult patients who received Cy-based mobilization regimen at doses 2 and 3 gr/m between 2018 and 2024. All patients included in this study were 18 years old and older. Patients divided into two groups; group 1 represents 2 gr/m treated patients, and group 2 represents 3 gr/m dosing. These two groups then compared in terms of CD34 cell number collected by apheresis, apheresis days, peak peripheral blood CD34 value and rates of mobilization failures.

Results: Higher doses of Cy yielded more hematopoietic stem cells compared to the lower dose Cy [10.00 (3.00-28.90) vs 9.01 (5.00-14.90), p = 0.002]; while mobilization failures and apheresis days were comparable across groups (p = 0.112 and p = 0.648, respectively). Apheresis days required for adequate stem cell harvest among groups was found statistically similar (p = 0.648).

Conclusion: This study indicated the superior efficacy of 3 gr/m dose of Cy in terms of stem cell yield. However, mobilization failure and prolonged apheresis sessions were not issues with lower doses.

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http://dx.doi.org/10.1016/j.transci.2025.104183DOI Listing

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