Abstract:
:Autologous stem cell transplantation (PBSCT) is standard for young patients in MM and its TRM has decreased after the 2000s. Bortezomib and immunomodulatory agents (IMiDs) in MM have improved the outcome. However, they seem to boost pro-inflammatory stage increasing the incidence of engraftment syndrome (ES). Favorable factors in PBSCT such as G-CSF could increase inflammatory stage during transplant. Corticosteroids have shown an excellent response of ES and some authors propose them as prophylaxis for ES. The aim was to analyze the impact of G-CSF avoidance and corticosteroids' prophylaxis in 170 patients diagnosed of MM treated with bortezomib/IMiDs that underwent PBSCT. We established three groups: Group-I [(G-CSF_administration), 60 patients (35%)], group-II [(nonG-CSF), 60 patients (35%)] and group-III [(nonG-CSF plus corticosteroid's prophylaxis), 50 patients (30%)]. A decreased ES incidence among groups was observed: 62, 42, and 22% (P < 0.0001). The incidence of symptoms mimicking a capillary leak syndrome associated with ES dropped: 43, 32, and 0% (P = 0.03). The G-CSF avoidance and corticosteroids had impact over admission 24, 21, and 20 days (P = 0.001). The most important variables related to ES were HCT-CI >2 (p < 0.0001; HR 8.5) and risk groups (p < 0.0001; HR 7.2). Hence, G-CSF avoidance and corticosteroid's prophylaxis decrease morbidity in patients undergoing PBSCT with MM treated with bortezomib/IMiDs.
journal_name
Bone Marrow Transplantjournal_title
Bone marrow transplantationauthors
Gutiérrez-García G,Rovira M,Magnano L,Rosiñol L,Bataller A,Suárez-Lledó M,Cibeira MT,de Larrea CF,Garrote M,Jorge S,Moreno A,Rodríguez-Lobato LG,Carreras E,Díaz-Ricart M,Palomo M,Martínez C,Urbano-Ispizua A,Bladé J,Fedoi
10.1038/s41409-018-0189-2subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1541-1547issue
12eissn
0268-3369issn
1476-5365pii
10.1038/s41409-018-0189-2journal_volume
53pub_type
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journal_title:Bone marrow transplantation
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journal_title:Bone marrow transplantation
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journal_title:Bone marrow transplantation
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
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journal_title:Bone marrow transplantation
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,多中心研究
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
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更新日期:1998-07-01 00:00:00
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
doi:
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
doi:
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
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journal_title:Bone marrow transplantation
pub_type: 杂志文章
doi:
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journal_title:Bone marrow transplantation
pub_type: 临床试验,杂志文章
doi:
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