A284 Cytarabine-Based Regimens for Mobilization of Peripheral Blood Stem Cells in Multiple Myeloma

Abstract

this difference in outcomes may reflect differences in adrenal suppression, we studied patients from our myeloma database. Early morning serum cortisol levels at baseline and again at 3 months were determined to compare adrenal function in patients with MM receiving either lowor high-dose dexamethasone. At baseline, 8 AM serum cortisol levels were not different between the groups. At 3 months, 72.7% of the high-dose group had a decline in their 8 AM cortisol levels compared to 32.4% of the low-dose group (P = .03). The proportion of patients with a 3-month 8 AM serum cortisol level below 3 mcg/dL, a level considered to be presumptive evidence of adrenal suppression, was also increased in the high dose group (45.5% vs. 8.8%; P = .01). Overall, the high-dose dexamethasone group experienced a mean decline of 6.4 mcg/dL in their 8 AM serum cortisol levels after 3 months (95% CI, –10.7 to –2.1), while the low-dose group demonstrated no significant change (95% CI, –0.2 to 4.3). Additional studies are needed to determine the impact of corticosteroid-induced adrenal insufficiency on important treatment outcomes such as symptom relief and prognosis.