Differences in engraftment with day-1 compared with day-2 melphalan prior to stem cell infusion in myeloma patients receiving autologous stem cell transplant

Abdullah S. Al Saleh, M. Hasib Sidiqi, Jae Won Lee, Angela Dispenzieri, Eli Muchtar, Francis K. Buadi, Rahma Warsame, Martha Q. Lacy, David Dingli, Nelson Leung, Wilson I. Gonsalves, Prashant Kapoor, Taxiarchis V. Kourelis, Christel A. Skaer, Sarah K. Wittwer, Robert C. Wolf, William J. Hogan, Shaji K. Kumar, Eapen Jacob, Morie A. Gertz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

We conducted a retrospective study comparing posttransplant outcomes between myeloma patients receiving conditioning melphalan on day-2 vs day-1 for autologous stem cell transplant. Between January 2017 and December 2018, 201 patients received melphalan on day-2 and 166 on day-1 prior to stem cell infusion. Baseline disease and clinical characteristics between the two groups were similar. Although rates of hospitalization were similar between the cohorts, duration of hospital admission was longer for day-1 (median 7 days for day-1 vs 5 days for day-2, p = 0.003). Rates of fever were higher in the day-1 cohort (69% vs 49%, p = 0.0002). Time to platelet and neutrophil engraftment was significantly longer in the day-1 cohort (platelet engraftment median days 17 for day-1 vs 15 for day-2, p < 0.0001, neutrophil engraftment median days 16 for day-1 vs 16 for day-2, p = 0.025). Overall response rate was similar between the cohorts (99% for day-1, vs 100% for day-2). Day-2 melphalan infusions should be considered in preference for day-1 protocols, given the clinically significant delay in platelet and neutrophil engraftment and longer duration of hospitalization with day-1 infusions.

Original languageEnglish (US)
Pages (from-to)2132-2137
Number of pages6
JournalBone Marrow Transplantation
Volume55
Issue number11
DOIs
StatePublished - Nov 1 2020

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint Dive into the research topics of 'Differences in engraftment with day-1 compared with day-2 melphalan prior to stem cell infusion in myeloma patients receiving autologous stem cell transplant'. Together they form a unique fingerprint.

Cite this