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) has proved to be an effective salvage therapy for refractory-relapsed MM patients. Li ttle 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 t o define its toxicity. Fifty-five MM patients received DCEP followed by GCS F as part of high-dose programs including autologous transplantation. At th e time of mobilization, 40 patients had previously received VAD only, and 1 5 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%) coll ected >4 x 10(6)/kg CD34(+) cells. Of the seven patients who did not mobili ze 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 < 500 00/mul were observed. No patient required transfusion as a consequence of t herapy, or hospitalization for septic complications. In conclusion, DCEP, i n 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 f or the debulking and mobilization phase of high-dose programs for multiple myeloma.