{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:44:38Z","timestamp":1782218678775,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Empiris foundation, Zurich, Switzerland"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>In fit patients with newly diagnosed myeloma, high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) is considered standard of care. For mobilization of CD34+ cells for ASCT, combined cytotoxic chemotherapy and G-CSF is commonly used. However, the importance of cytostatic chemotherapy for reliable mobilization remains unclear. This prospective randomized phase II non-inferiority trial compared G-GSF only (G) compared to standard chemotherapy\/G-CSF (CG) for CD34+ mobilization. The primary endpoint was a less than 15% difference in successful stem cell collection (\u2009\u2265\u20095.0\u2009\u00d7\u200910<jats:sup>6<\/jats:sup> CD34+ cells\/kg b.w. in a single day collection procedure without additional stimulation with plerixafor) with the G regimen. 136 patients were 1:1 randomized. With an 18% difference in favor of the CG therapy, the non-inferiority margin was not maintained (95% CI 1%, 34%, <jats:italic>p<\/jats:italic>\u2009=\u20090.04). The median total CD34+ yield was 9.99\u2009\u00d7\u200910<jats:sup>6<\/jats:sup>\/kg b.w. in CG patients and 7.42\u2009\u00d7\u200910<jats:sup>6<\/jats:sup>\/kg b.w. in patients with G-CSF alone (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Ultimately, 130 (96%) patients proceeded to HDCT with ASCT. There were no differences in adverse events, hematologic engraftment, quality of life, or pain perception between the groups. Our data indicate that G-CSF only is inferior to chemotherapy with G-CSF for peripheral CD34+ stem cell mobilization. Trial registration SNCTP #: SNCTP000002952; Trials.gov #: NCT03442673.<\/jats:p>","DOI":"10.1038\/s41409-024-02468-z","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T10:47:31Z","timestamp":1731667651000},"page":"270-276","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparing stem cell mobilization with chemotherapy and cytokine (G-CSF) versus cytokine alone in myeloma patients (MOCCCA): a randomized phase II, open-label, non-inferiority trial"],"prefix":"10.1038","volume":"60","author":[{"given":"Barbara","family":"Jeker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Thalmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Bacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Nilius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00eblle","family":"Rhyner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"S\u00f6kler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Soltermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Winkler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Vorburger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8138-0505","authenticated-orcid":false,"given":"Michael","family":"Daskalakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mich\u00e8le","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-5257","authenticated-orcid":false,"given":"Thomas","family":"Pabst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"2468_CR1","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","volume":"376","author":"M Attal","year":"2017","unstructured":"Attal M, Lauwers-Cances V, Hulin C, Leleu X, Caillot D, Escoffre M, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N. Engl J Med. 2017;376:1311\u201320.","journal-title":"N. Engl J Med"},{"key":"2468_CR2","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.annonc.2020.11.014","volume":"32","author":"MA Dimopoulos","year":"2021","unstructured":"Dimopoulos MA, Moreau P, Terpos E, Mateos MV, Zweegman S, Cook G, et al. Multiple myeloma: EHA-ESMO clinical practice guidelines for diagnosis, treatment and follow-up\u2020. Ann Oncol. 2021;32:309\u201322.","journal-title":"Ann Oncol"},{"key":"2468_CR3","doi-asserted-by":"publisher","first-page":"6063","DOI":"10.1182\/blood-2011-02-297325","volume":"117","author":"M Cavo","year":"2011","unstructured":"Cavo M, Rajkumar SV, Palumbo A, Moreau P, Orlowski R, Blad\u00e9 J, et al. International Myeloma Working Group consensus approach to the treatment of multiple myeloma patients who are candidates for autologous stem cell transplantation. Blood. 2011;117:6063\u201373.","journal-title":"Blood"},{"key":"2468_CR4","doi-asserted-by":"publisher","first-page":"2699","DOI":"10.3390\/cancers15102699","volume":"15","author":"C Gillich","year":"2023","unstructured":"Gillich C, Akhoundova D, Hayoz M, Aebi Y, Largiad\u00e8r CR, Seipel K, et al. Efficacy and safety of high-dose chemotherapy with treosulfan and melphalan in multiple myeloma. Cancers. 2023;15:2699.","journal-title":"Cancers"},{"key":"2468_CR5","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1038\/s41409-022-01681-y","volume":"57","author":"S Farag","year":"2022","unstructured":"Farag S, Bacher U, Jeker B, Legros M, Rhyner G, L\u00fcthi JM, et al. Adding bendamustine to melphalan before ASCT improves CR rate in myeloma vs. melphalan alone: a randomized phase-2 trial. Bone Marrow Transpl. 2022;57:990\u20137.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR6","doi-asserted-by":"publisher","first-page":"371","DOI":"10.6004\/jnccn.2004.0030","volume":"2","author":"WI Bensinger","year":"2004","unstructured":"Bensinger WI. The role of hematopoietic stem cell transplantation in the treatment of multiple myeloma. J Natl Compr Cancer Netw. 2004;2:371\u20138.","journal-title":"J Natl Compr Cancer Netw"},{"key":"2468_CR7","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1182\/blood.2020005288","volume":"136","author":"PM Voorhees","year":"2020","unstructured":"Voorhees PM, Kaufman JL, Laubach J, Sborov DW, Reeves B, Rodriguez C, et al. Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood. 2020;136:936\u201345.","journal-title":"Blood"},{"key":"2468_CR8","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1056\/NEJMoa022340","volume":"348","author":"JA Child","year":"2003","unstructured":"Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K, et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N. Engl J Med. 2003;348:1875\u201383.","journal-title":"N. Engl J Med"},{"key":"2468_CR9","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1038\/bmt.2013.52","volume":"48","author":"F Awan","year":"2013","unstructured":"Awan F, Kochuparambil ST, Falconer DE, Cumpston A, Leadmon S, Watkins K, et al. Comparable efficacy and lower cost of PBSC mobilization with intermediate-dose cyclophosphamide and G-CSF compared with plerixafor and G-CSF in patients with multiple myeloma treated with novel therapies. Bone Marrow Transpl. 2013;48:1279\u201384.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR10","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1002\/jca.21280","volume":"28","author":"L Chaudhary","year":"2013","unstructured":"Chaudhary L, Awan F, Cumpston A, Leadmon S, Watkins K, Tse W, et al. Peripheral blood stem cell mobilization in multiple myeloma patients treat in the novel therapy\u2010era with plerixafor and G\u2010CSF has superior efficacy but significantly higher costs compared to mobilization with low\u2010dose cyclophosphamide and G\u2010CSF. J Clin Apher. 2013;28:359\u201367.","journal-title":"J Clin Apher"},{"key":"2468_CR11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.bbmt.2014.09.020","volume":"21","author":"P Samaras","year":"2015","unstructured":"Samaras P, Pfrommer S, Seifert B, Petrausch U, Mischo A, Schmidt A, et al. Efficacy of vinorelbine plus granulocyte colony\u2013stimulation factor for CD34+ hematopoietic progenitor cell mobilization in patients with multiple myeloma. Biol Blood Marrow Transplant. 2015;21:74\u201380.","journal-title":"Biol Blood Marrow Transplant"},{"key":"2468_CR12","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1038\/bmt.2017.234","volume":"53","author":"B Jeker","year":"2018","unstructured":"Jeker B, Novak U, Mansouri Taleghani B, Baerlocher GM, Seipel K, Mueller BU, et al. NSAID treatment with meloxicam enhances peripheral stem cell mobilization in myeloma. Bone Marrow Transpl. 2018;53:175\u20139.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR13","doi-asserted-by":"publisher","first-page":"2047","DOI":"10.1038\/s41409-020-0875-8","volume":"55","author":"B Jeker","year":"2020","unstructured":"Jeker B, Farag S, Taleghani BM, Novak U, Mueller BU, Li Q, et al. A randomized evaluation of vinorelbine versus gemcitabine chemotherapy mobilization of stem cells in myeloma patients. Bone Marrow Transpl. 2020;55:2047\u201351.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR14","doi-asserted-by":"publisher","first-page":"430","DOI":"10.3390\/cancers15020430","volume":"15","author":"S B\u00fchler","year":"2023","unstructured":"B\u00fchler S, Akhoundova D, Jeker B, Legros M, Seipel K, Daskalakis M, et al. Stem cell mobilization with Ixazomib and G-CSF in patients with multiple myeloma. Cancers. 2023;15:430.","journal-title":"Cancers"},{"key":"2468_CR15","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/j.leukres.2015.03.015","volume":"39","author":"S Keller","year":"2015","unstructured":"Keller S, Seipel K, Novak U, Mueller BU, Taleghani BM, Leibundgut K, et al. Neurotoxicity of stem cell mobilization chemotherapy with vinorelbine in myeloma patients after bortezomib treatment. Leuk Res. 2015;39:786\u201392.","journal-title":"Leuk Res"},{"key":"2468_CR16","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1136\/jnnp.61.4.409","volume":"61","author":"A Pace","year":"1996","unstructured":"Pace A, Bove L, Nistico C, Ranuzzi M, Innocenti P, Pietrangeli A, et al. Vinorelbine neurotoxicity: clinical and neurophysiological findings in 23 patients. J Neurol Neurosurg Psychiatry. 1996;61:409\u201311.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2468_CR17","doi-asserted-by":"publisher","first-page":"5436","DOI":"10.1182\/blood.V126.23.5436.5436","volume":"126","author":"BU Mueller","year":"2015","unstructured":"Mueller BU, Keller S, Seipel K, Mansouri Taleghani B, Pabst T. Stem cell mobilization chemotherapy with gemcitabine is effective and safe in myeloma patients with bortezomib induced neurotoxicity. Blood. 2015;126:5436.","journal-title":"Blood"},{"key":"2468_CR18","doi-asserted-by":"publisher","first-page":"5720","DOI":"10.1182\/blood-2008-08-174946","volume":"113","author":"JF DiPersio","year":"2009","unstructured":"DiPersio JF, Stadtmauer EA, Nademanee A, Micallef INM, Stiff PJ, Kaufman JL, et al. Plerixafor and G-CSF versus placebo and G-CSF to mobilize hematopoietic stem cells for autologous stem cell transplantation in patients with multiple myeloma. Blood. 2009;113:5720\u20136.","journal-title":"Blood"},{"key":"2468_CR19","doi-asserted-by":"publisher","first-page":"608","DOI":"10.3109\/10428194.2014.927454","volume":"56","author":"A Schmid","year":"2015","unstructured":"Schmid A, Friess D, Mansouri Taleghani B, Keller P, Mueller BU, Baerlocher GM, et al. Role of plerixafor in autologous stem cell mobilization with vinorelbine chemotherapy and granulocyte-colony stimulating factor in patients with myeloma: a phase II study (PAV-trial). Leuk Lymphoma. 2015;56:608\u201314.","journal-title":"Leuk Lymphoma"},{"key":"2468_CR20","doi-asserted-by":"publisher","first-page":"403","DOI":"10.2147\/JBM.S307520","volume":"12","author":"YM Bilgin","year":"2021","unstructured":"Bilgin YM. Use of plerixafor for stem cell mobilization in the setting of autologous and allogeneic stem cell transplantations: an update. J Blood Med. 2021 12:403\u201312.","journal-title":"J Blood Med"},{"key":"2468_CR21","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1002\/hon.3055","volume":"41","author":"M Maechler","year":"2023","unstructured":"Maechler M, Bacher U, Daskalakis M, Nilius H, Nagler M, Taleghani BM, et al. Long\u2010term safety of the stem cell releasing compound plerixafor for peripheral stem cell collection in myeloma patients. Hematol Oncol. 2023;41:583\u20136.","journal-title":"Hematol Oncol"},{"key":"2468_CR22","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1038\/bmt.2008.369","volume":"43","author":"MA Gertz","year":"2009","unstructured":"Gertz MA, Kumar SK, Lacy MQ, Dispenzieri A, Hayman SR, Buadi FK, et al. Comparison of high-dose CY and growth factor with growth factor alone for mobilization of stem cells for transplantation in patients with multiple myeloma. Bone Marrow Transpl. 2009;43:619\u201325.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR23","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1038\/s41409-018-0152-2","volume":"53","author":"CC Chua","year":"2018","unstructured":"Chua CC, Lim HY, Chai KL, Ong J, Sim S, Wood C, et al. Peripheral blood stem cell mobilisation with G-CSF alone versus G-CSF and cyclophosphamide after bortezomib, cyclophosphamide and dexamethasone induction in multiple myeloma. Bone Marrow Transpl. 2018;53:1116\u201323.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR24","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1038\/sj.bmt.1703787","volume":"31","author":"MJ Bargetzi","year":"2003","unstructured":"Bargetzi MJ, Passweg J, Baertschi E, Schoenenberger A, Gwerder C, Tichelli A, et al. Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective. Bone Marrow Transpl. 2003;31:99\u2013103.","journal-title":"Bone Marrow Transpl"},{"key":"2468_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2020.102819","volume":"59","author":"D Laszlo","year":"2020","unstructured":"Laszlo D, Marcacci GP, Martino M, Radice D, Rabascio C, Lucchetti B, et al. A comparison of chemo-free strategy with G-CSF plus plerixafor on demand versus intermediate-dose cyclophosphamide and G-CSF as PBSC mobilization in newly diagnosed multiple myeloma patients: an Italian explorative cost analysis. Transfus Apheresis Sci. 2020;59:102819.","journal-title":"Transfus Apheresis Sci"},{"key":"2468_CR26","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1477-7525-12-35","volume":"12","author":"I Proskorovsky","year":"2014","unstructured":"Proskorovsky I, Lewis P, Williams CD, Jordan K, Kyriakou C, Ishak J, et al. Mapping EORTC QLQ-C30 and QLQ-MY20 to EQ-5D in patients with multiple myeloma. Health Qual Life Outcomes. 2014;12:35.","journal-title":"Health Qual Life Outcomes"},{"key":"2468_CR27","doi-asserted-by":"publisher","first-page":"2260","DOI":"10.1016\/0959-8049(95)00296-0","volume":"31","author":"S Kaasa","year":"1995","unstructured":"Kaasa S, Bjordal K, Aaronson N, Moum T, Wist E, Hagen S, et al. The EORTC core quality of life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy. Eur J Cancer. 1995;31:2260\u20133.","journal-title":"Eur J Cancer"},{"key":"2468_CR28","doi-asserted-by":"publisher","unstructured":"Boonstra AM, Stewart RE, K\u00f6ke AJA, Oosterwijk RFA, Swaan JL, Schreurs KMG, et al. Cut-off points for mild, moderate, and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain: variability and influence of sex and catastrophizing. Front Psychol. 2016;7. https:\/\/doi.org\/10.3389\/fpsyg.2016.01466.","DOI":"10.3389\/fpsyg.2016.01466"},{"key":"2468_CR29","unstructured":"International Myeloma Foundation. https:\/\/www.myeloma.org\/autologous-stem-cell-transplant (accessed 12 Mar 2024)."},{"key":"2468_CR30","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2329140","volume":"56","author":"Y Li","year":"2024","unstructured":"Li Y, Qiu X, Lei Y, Zhou R. G-CSF\u2009+\u2009plerixafor versus G-CSF alone mobilized hematopoietic stem cells in patients with multiple myeloma and lymphoma: a systematic review and meta-analysis. Ann Med. 2024;56:2329140.","journal-title":"Ann Med"},{"key":"2468_CR31","doi-asserted-by":"publisher","unstructured":"Sar\u0131c\u0131 A, Erkurt MA, Bah\u00e7ecio\u011flu \u00d6F, G\u00f6k S, Kuku \u0130, Bi\u00e7im S, et al. Filgrastim alone versus cyclophosphamide and filgrastim for mobilization in multiple myeloma patients. Transfus Apher Sci. 2021;60. https:\/\/doi.org\/10.1016\/j.transci.2021.103159.","DOI":"10.1016\/j.transci.2021.103159"},{"key":"2468_CR32","doi-asserted-by":"publisher","first-page":"590.e1","DOI":"10.1016\/j.jtct.2021.04.016","volume":"27","author":"A Johnsrud","year":"2021","unstructured":"Johnsrud A, Ladha A, Muffly L, Shiraz P, Goldstein G, Osgood V, et al. Stem cell mobilization in multiple myeloma: comparing safety and efficacy of cyclophosphamide +\/\u2212 plerixafor versus granulocyte colony-stimulating factor +\/\u2212 plerixafor in the lenalidomide era. Transpl Cell Ther. 2021;27:590.e1\u2013590.e8.","journal-title":"Transpl Cell Ther"}],"container-title":["Bone Marrow Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41409-024-02468-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-024-02468-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41409-024-02468-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:45:57Z","timestamp":1741862757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41409-024-02468-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["2468"],"URL":"https:\/\/doi.org\/10.1038\/s41409-024-02468-z","relation":{},"ISSN":["0268-3369","1476-5365"],"issn-type":[{"value":"0268-3369","type":"print"},{"value":"1476-5365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]},"assertion":[{"value":"2 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"MD received financial support for attending haematology meetings from Kite Gilead\/Novartis and serves as an advisory board member for Novartis. There are no financial disclosures from any of the other authors.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"We confirm that all methods were performed in accordance with the relevant guidelines and regulations. The study had approval by the local Ethics Committee of Bern, Switzerland, with the decision number 2018-00615. Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}