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

Authors : Filiz Mercan Sarıdaş, Vildan Ozkocaman, Fahir Özkalemkaş

Pages : 367-373

Doi:10.32708/uutfd.1518837

View : 59 | Download : 87

Publication Date : 2025-01-12

Article Type : Research Paper

Abstract :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 mg/m²) and granulocyte colony-stimulating factor (G-CSF, 10-15 μg/kg 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 (> 2x106/kg 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 × 10⁶/kg (11.7 in good vs 3.98 in poor mobilizers, p<0.001). 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; p=0.040) and prior autologous hematopoietic stem cell transplantation (HR; 1.206, 95% CI 1.009-1.442; p=0.043) were independent risk factors for poor mobilization. Febrile neutropenia occurred in 18.8% (11.4% in good vs 38.5% in poor mobilizers, p=0.048), and 16.7% required erythrocyte transfusions (14.3% in good vs 23.1% in poor mobilizers, p=0.664). 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.
Keywords : düşük doz etoposid, kök hücre mobilizasyonu, multiple miyelom, lenfoma, otolog hematopoetik kök hücre transplantasyonu

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