Optimized EAP regimen delivers outstanding mobilization effects in multiple myeloma and lymphoma patients

This prospective, multicenter phase II study was conducted across 12 medical institutions in China and registered at ClinicalTrials.gov (NCT05536154). A total of 68 eligible patients with multiple myeloma or lymphoma were initially enrolled, and 65 completed the trial, including 34 multiple myeloma patients and 31 lymphoma patients. All participants had not received prior stem cell mobilization and were suitable for autologous hematopoietic stem cell transplantation.

The researchers adopted an optimized EAP regimen combining etoposide, cytarabine, and pegfilgrastim for first-line mobilization. Dose reduction was applied to elderly patients and those with impaired renal function. Medical staff monitored peripheral blood CD34+ cell counts daily and initiated leukapheresis according to unified criteria. Only 3.1% of patients needed additional plerixafor during the whole process.

The optimized EAP regimen delivered outstanding mobilization effects. All 65 patients reached the standard for adequate stem cell collection, and 90.8% achieved optimal mobilization. Most patients finished cell collection with a single apheresis, with the median total CD34+ cell yield reaching 14.7 ×10⁶ cells/kg. No significant differences in mobilization efficacy were found between multiple myeloma and lymphoma groups. The study led by Chief Physician Dr. Ying Lu was made available online on July 09, 2026, in the Chinese Medical Journal.

In terms of safety, hematological toxicities were the main adverse reactions. Grade 4 neutropenia and thrombocytopenia were commonly observed, yet most cases were well managed with supportive treatments such as blood transfusion and thrombopoietin. Only mild to moderate infections occurred, and no severe fatal complications were reported. Overall, the regimen showed good clinical tolerability.

Fifty-two patients eventually received autologous hematopoietic stem cell transplantation. Their neutrophil and platelet engraftment proceeded smoothly, and lymphoma patients presented slightly faster hematopoietic recovery. The study also acknowledged limitations including the relatively small sample size and heterogeneous baseline conditions of participants. Two large-sample phase III randomized trials are now underway for further verification.

In conclusion, the refined EAP regimen acts as an effective and well-tolerated first-line mobilization option for patients with multiple myeloma and lymphoma, providing a practical alternative to conventional mobilization strategies.