Progression-Free Survival Following Autologous Transplantation for Multiple Myeloma is Not Compromised by the Use of Dose-Adjusted Melphalan

e154 factor for the mobilization of CD34+ progenitor cells. The mobilization protocols attempt to supplant such a condition associating other treatments to the granulocyte growth factor (G-CSF), such as cyclo. The CD34+ cell target for a single transplant has been 4 to 6 x 106 CD34+/kg, the acceptable minimum in avoiding damage upon harvesting the bone marrow being 2x106 CD34+/Kg. ObjectiveTo evaluate the number of CD34+ cells mobilized in the use of GCSF Vs GCSF+cyclo following induction with the schedule cyclo+thal+dexamethasone (dex)(CTD) in MM patients who are eligible for high-dose chemotherapy. The harvesting > 2.0x 106/kg CD34+ cells was considered adequate. Cases and methods A retrospective cohort of MM patients submitted to TACPH at two Brazilian centers from May 2009 to July 2013. Induction 1⁄4 CTDcenter 1 (cyclo 50mg/day, thal 100-200mg/day, dex 160mg/month and center 21⁄4 cyclo 500mg D1, 8 and 15, thal 100mg/day and dex 200-400mg/month, all drugs being administered orally. Mobilization 1⁄4 GCSF + cyclo (GCSF 10-15mcg/kg for 5 days + cyclo34g/m or GCSF15-20mcg/kg for 5 days isolatedly). Results Ninety-two patients were analyzed. In relation to mobilization, 70 patients received isolated filgrastim, 18 received a combination of filgrastim and cyclophosphamide, 2 patients were not submitted to mobilization and in two cases the schedule was not reported. Median general age was 58 years (51-62), 58 years (53-61) for GCSF and 56.5 years (54-60) for GCSF + cyclo. Fifty-two patients were males . Concerning the DS IIIA/B 1⁄4 80 cases (90.9%) and ISS 2 and 3 1⁄4 38 cases (44.7%) and 20 cases (23.5%). The filgrastim+ cyclo group had the highest average number of collected progenitor cells, 6.4 7.7, VS 3.4 1.3 in the isolated filgrastim group (p 1⁄4 0.008). No correlation was observed between better responses and higher number of mobilized cells. The filgrastim utilized was of a similar type for all the presented cases. Conclusions The number of cells mobilized with GCSF + cyclo is superior to the number mobilized with isolated GCSF. However, the average number of CD34+ was sufficient to perform a single TACPH, with no detriment to harvesting. In addition, the type of filgrastim used was biosimilar, conferring a satisfactory response with said agent.