Blood stem cell collections after mobilization with combination chemotherapy containing ifosfamide followed by G-CSF in multiple myeloma

High-dose chemotherapy with autologous peripheral blood stem cell
transplantation is the standard treatment of patients with multiple
myeloma today. In this study we used a combination mobilizing
chemotherapy containing ifosfamide with G-CSF before stem cell
collection. The chemotherapy regimen consisted of ifosfamide (2,500
mg/m(2) days 1-3), epirubicin (100 mg/m(2) day 1) and etoposide
(150 mg/m2 days 1-3) followed by G-CSF (5 mug/kg from day 5). In 30
younger patients (median age 51 years; range 41-60 years) who
received the IEV regimen in 100% dosage, a median of 11.15 x 10(6)
CD34(+) cells/kg (range 0-44.60 x 10(6) CD34(+) cells/kg) was
collected. In 22 elder patients (median age 64 years; range 59-72
years) similar collection results were obtained with a median of
10.82 x 10(6) CD34(+) cells/kg (range 0.99-42.22 x 10(6) CD34(+)
cells/kg) after the IEV regimen in 75% dosage. The pretreatment
chemotherapy cycles before mobilization were fewer in elder
patients with a median of 0 cycles (range 0-7 cycles) compared with
younger patients with a median of 4 cycles (range 0-7 cycles).
These collection results were favorable and allowed to support a
tandem transplantation procedure in younger and elder patients in
97 and 95%, respectively. In the majority of patients, the
hematological toxicity of IEV was of WHO grade 3/4. The
extramedullary toxicity was mild to moderate and there were only
few cases (5-10%) of relevant nephrotoxicity or neurotoxicity
associated with the application of ifosfamide. Copyright (C) 2003
S. Karger AG, Basel.