Stem Cell Transplant With or Without Tbo-filgrastim in Treating Patients With Multiple Myeloma or Non-Hodgkin Lymphoma

PRIMARY OBJECTIVE:

I. To demonstrate non-inferiority in the number of days to discharge readiness after a granulocyte colony-stimulating factor (G-CSF) + plerixafor-mobilized autologous stem cell transplant in patients receiving versus not receiving post-transplant growth factor support.

SECONDARY OBJECTIVE:

I. To compare days to absolute neutrophil count (ANC) > 500, days to platelet engraftment, febrile days, days of febrile neutropenia, documented infections, and number of antibiotic days in patients receiving versus not receiving post-transplant growth factor support.

EXPLORATORY OBJECTIVE:

I. To evaluate immunological recovery (lymphocyte number including CD 3/4 and CD3/8 T cell subsets) at day + 60 in patients receiving versus not receiving post-transplant growth factor support.

Inclusion criteria

• Undergoing autologous stem cell transplant for one of the following diagnoses:

• Multiple myeloma
• Non-Hodgkin lymphoma
• Karnofsky performance status of >= 70%
• Patients must meet the Thomas Jefferson University Hospital (TJUH) bone marrow transplant (BMT) standard of procedure (SOP) guidelines for "Patient Criteria for Autologous HSCT"
• Left ventricular ejection fraction (LVEF) of ≥ 40%
• Adjusted Carbon monoxide diffusing capability (DLCO) > 45% of predicted corrected for hemoglobin
• Serum bilirubin < 1.8
• Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 2.5 X upper limit of normal
• Serum creatinine =< 2.0 mg/dl and/or creatinine clearance of > 40 ml/min (excludes multiple myeloma patients receiving high dose melphalan conditioning)
• Willingness to use contraception if childbearing potential
• Has the ability to give informed consent, or for cognitively or decisionally impaired individuals (vulnerable population), the availability of a family member or guardian to give consent and assist in the consent process
• Life expectancy of > 12 months (exclusive of the disease for which the auto HSCT is being performed)
• Patients must have undergone stem cell mobilization with the combination of G-CSF and plerixafor as per TJUH BMT SOP guidelines
• Collection of an adequate number of CD34+ stem cells, i.e. >= 4-6 x 10^6/kg from apheresis

Exclusion criteria

• Uncontrolled human immunodeficiency virus (HIV)
• Uncontrolled bacterial infection
• Active central nervous system (CNS) disease
• Pregnancy or lactation
• Evidence of another malignancy, exclusive of a skin cancer that requires only local treatment