DCEP (dexamethasone, cyclophosphamide, etoposide, and cisplatin) is an effective regimen for peripheral blood stem cell collection in multiple myeloma
DCEP (dexamethasone, cyclophosphamide, etoposide, and cisplatin) is an effective regimen for peripheral blood stem cell collection in multiple myeloma
复制标题
DOI：
10.1038/sj.bmt.1703240
复制
发表时间：
2001-11-01
影响因子：
4.8
通讯作者：
Morra, E
中科院分区：
文献类型：
--
作者：
Lazzarino, M;Corso, A;Morra, E
DCEP（地塞米松、环磷酰胺、依托泊苷和顺铂）已被证明是难治性复发MM患者的有效挽救治疗。然而，人们对其作为动员疗法的潜力知之甚少。本研究的目的是评估DCEP动员PBSC的有效性并确定其毒性。55例MM患者接受DCEP，随后接受GCSF作为高剂量方案（包括自体移植）的一部分。在动员时，40例患者既往仅接受过VAD和15种烷化剂。55例患者中有48例（87%）动员成功（CD 34（+）细胞最低数量为2 x 10（6）/kg），55例患者中有41例（75%）收集到>4 x 10（6）/kg的CD 34（+）细胞。在7名没有动员干细胞的患者中，5名（71%）以前曾暴露于烷化剂。收获的CD 34（+）细胞的中位数为5.8 x 10（6）/kg（范围2.1-22.4）。无治疗相关死亡。DCEP的不良反应均可耐受。未观察到中性粒细胞减少症< 1000/穆尔或血小板减少症< 50000/穆尔。没有患者因治疗需要输血，或因败血症并发症住院。总之，DCEP，除了其已证实的抗肿瘤活性，是一种有效的方案动员外周血祖细胞在骨髓瘤患者，很少或没有副作用。这些特性使DCEP成为多发性骨髓瘤高剂量方案减积和动员阶段的有用方案。
DCEP (dexamethasone, cyclophosphamide, etoposide, and cisplatin) has proved to be an effective salvage therapy for refractory-relapsed MM patients. Little is known, however, about its potential as mobilizing therapy. The aim of this study was to evaluate the efficacy of DCEP in mobilizing PBSC and to define its toxicity. Fifty-five MM patients received DCEP followed by GCSF as part of high-dose programs including autologous transplantation. At the time of mobilization, 40 patients had previously received VAD only, and 15 alkylating agents. Mobilization was successful (minimum number of CD34(+) cells 2 x 10(6)/kg) in 48/55 patients (87%), and 41/55 patients (75%) collected >4 x 10(6)/kg CD34(+) cells. Of the seven patients who did not mobilize stem cells, five (71%) had been previously exposed to alkylating agents. The median number of CD34(+) cells harvested was 5.8 x 10(6)/kg (range 2.1-22.4). There was no treatment-related mortality. The side-effects of DCEP were always tolerable. No neutropenia < 1000/mul nor thrombocytopenia < 50000/mul were observed. No patient required transfusion as a consequence of therapy, or hospitalization for septic complications. In conclusion, DCEP, in addition to its demonstrated anti-tumor activity, is an effective regimen for mobilizing peripheral blood progenitor cells in myeloma patients, with little or no side-effects. These properties render DCEP a useful regimen for the debulking and mobilization phase of high-dose programs for multiple myeloma.