RAPID PROGRESSION OF MULTIPLE-MYELOMA FOLLOWING G-CSF MOBILIZATION

A 23-year-old man diagnosed as having multiple myeloma was treated wit h melphalan and prednisone monthly. After six cycles, an autologous pe ripheral blood stem cell transplantation (ABSCT) was planned. Peripher al blood mononuclear cells were collected after G-CSF mobilization (5 mu g/kg/day for 5 days). Ten days after the last dose of G-CSF the pat ient showed a striking progression of multiple myeloma. A 57% infiltra tion of plasma cells in bone marrow and recurrence of laboratory abnor malities were evident. The patient's clinical course strongly suggests that myeloma progression was triggered by G-CSF and supports the conc ept of G-CSF mediated autocrine stimulation of myeloma growth.