A randomized evaluation of vinorelbine versus gemcitabine chemotherapy mobilization of stem cells in myeloma patients

Jeker, Barbara; Farag, Sarah; Taleghani, Behrouz Mansouri; Novak, Urban; Mueller, Beatrice U.; Li, Qiyu; Betticher, Daniel; Luethi, Jean-Marc; Farese, Simone; Ruefer, Axel; Bacher, Ulrike; Pabst, Thomas

doi:10.1038/s41409-020-0875-8

Cited by 9 publications

(11 citation statements)

References 13 publications

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“…Five patients underwent mobilization chemotherapy with vinorelbine/G-CSF [ 38 ] and one with gemcitabine/G-CSF [ 39 ]. After G-CSF administration, autologous stem cells were obtained from peripheral blood in all patients.…”

Section: Resultsmentioning

confidence: 99%

BeEAM Conditioning including High-Dose Bendamustine before Autologous Stem Cell Transplantation Is Safe and Effective in Patients with Waldenstrom’s Macroglobulinemia

Heini

Beck

Bacher

et al. 2023

JCM

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High-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) is an option to consolidate remission in Waldenstrom’s macroglobulinemia (WM), particularly in selected younger patients with chemosensitive disease. BEAM, consisting of BCNU, etoposide, cytarabine, and melphalan, is often used as a conditioning regimen. However, problems with BCNU, including pneumotoxicity, tolerance, and availability, necessitate the search for alternatives. In this pilot study, we investigated high-dose chemotherapy with BeEAM, in which BCNU is replaced with high-dose bendamustine as an alternative conditioning regimen in six subsequent patients with WM. Bendamustine treatment was well tolerated without unexpected toxicities. The overall response rate was 6/6 patients (2 very good partial responses (VGPR) and 4 PR). After a median follow-up of 72 months, two (33%) patients relapsed. Median progression-free and overall survivals were not reached, and no severe late-onset toxicities were observed so far. In this pilot study, BeEAM conditioning before ASCT seems feasible, safe, and effective in patients with WM.

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Section: Resultsmentioning

confidence: 99%

BeEAM Conditioning including High-Dose Bendamustine before Autologous Stem Cell Transplantation Is Safe and Effective in Patients with Waldenstrom’s Macroglobulinemia

Heini

Beck

Bacher

et al. 2023

JCM

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“…2016 MM G-CSF SD; ID-AraC + G-CSF SD The ID-AraC group showed significantly higher total number of CD34 + cells collected ( P < 0.000001) and higher rate of reaching optimal target ( P = 0.0003)* Comprisons among chemotherapy regimens Chen et al [ 28 ] RCT, single center Jan. 2005–May 2010 NHL CY + G-CSF RD; MA + G-CSF RD The number of total CD34 + cells collected were similar ( P = 0.117) Pavone et al [ 54 ] RCT, single center NA NHL CY + G-CSF RD; DHAP + G-CSF RD No significant differences in the mean number of CD34 + cells collected Vela-Ojeda et al [ 62 ] RCT, single center Aug. 1994–Jun. 1999 NHL, HL or MM CY + GM-CSF RD; Ifosfamide + GM-CSF RD No significant differences in the number of CD34 + cells collected ( P = 0.1) Jeker et al [ 38 ] Phase 2 RCT, single center Dec. 2013–Apr. 2017 MM Vinorelbine + G-CSF SD; Gemcitabine + G-CSF SD The CD34 + cell yield was significantly higher in the Vinorelbine group ( P = 0.001)* Weaver et al [ 63 ] RCT, single center Sept. 1992–Aug.…”

Section: Resultsmentioning

confidence: 99%

“…The mobilization efficacy of salvage therapy regimen DHAP is compared with that of CY in patients with NHL, the results suggested no significant difference in the mean number of CD34 + cells collected (5.9 versus 7.06) [ 54 ]. Comparisons among other mobilizing chemotherapy reimens suggested that vinorelbine showed superior efficacy than gemcitabine in MM patients, the addition of methotrexate (MTX) to MEOD (mitoxantrone, etoposide, vindesine and dexamethasone) plus G-CSF can improve mobilization efficacy in NHL patients [ 38 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, RCT that directly compare the mobilization efficacy of ID-AraC versus CY is unavailable. In addition, it is suggested that some countries commonly used another chemotherapeutic agent vinorelbine plus G-CSF as standard HSCs mobilizaion regimen for patients with MM [ 38 , 57 ]. Well-designed RCTs comparing these regimens will be helpful to establish our results and determine the optimal mobilization regimens for MM patients.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of hematopoietic stem cell mobilization regimens in patients with hematological malignancies: a systematic review and network meta-analysis of randomized controlled trials

Luo

Huang

et al. 2022

Stem Cell Res Ther

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Background Efficient mobilization of hematopoietic stem cells (HSCs) from bone marrow niche into circulation is the key to successful collection and transplantation in patients with hematological malignancies. The efficacy of various HSCs mobilization regimens has been widely investigated, but the results are inconsistent. Methods We performed comprehensive databases searching for eligible randomized controlled trials (RCTs) that comparing the efficacy of HSCs mobilization regimens in patients with hematological malignancies. Bayesian network meta-analyses were performed with WinBUGS. Standard dose of granulocyte colony-stimulating factor (G-CSF SD) was chosen as the common comparator. Estimates of relative treatment effects for other regimens were reported as mean differences (MD) or odds ratio (OR) with associated 95% credibility interval (95% CrI). The surface under the cumulative ranking curve (SUCRA) were obtained to present rank probabilities of all included regimens. Results Databases searching and study selection identified 44 eligible RCTs, of which the mobilization results are summarized. Then we compared the efficacy of mobilization regimens separately for patients with multiple myeloma (MM) and non-Hodgkin lymphoma (NHL) by including 13 eligible trials for network meta-analysis, involving 638 patients with MM and 592 patients with NHL. For patients with MM, data are pooled from 8 trials for 6 regimens, including G-CSF in standard dose (SD) or reduced dose (RD) combined with cyclophosphamide (CY), intermediate-dose cytarabine (ID-AraC) or plerixafor. The results show that compared with G-CSF SD alone, 3 regimens including ID-AraC + G-CSF SD (MD 14.29, 95% CrI 9.99–18.53; SUCRA 1.00), G-CSF SD + Plerixafor SD (MD 4.15, 95% CrI 2.92–5.39; SUCRA 0.80), and CY + G-CSF RD (MD 1.18, 95% CrI 0.29–2.07; SUCRA 0.60) are associated with significantly increased total number of collected CD34+ cells (× 106/kg), among which ID-AraC + G-CSF SD ranked first with a probability of being best regimen of 100%. Moreover, ID-AraC + G-CSF SD and G-CSF SD + Plerixafor SD are associated with significantly higher successful rate of achieving optimal target (collecting ≥ 4–6 × 106 CD34+ cells/kg). For patients with NHL, data are pooled from 5 trials for 4 regimens, the results show that compared with G-CSF SD alone, G-CSF SD + Plerixafor SD (MD 3.62, 95% CrI 2.86–4.38; SUCRA 0.81) and G-CSF SD plus the new CXC chemokine receptor-4 (CXCR-4) antagonist YF-H-2015005 (MD 3.43, 95% CrI 2.51–4.35; SUCRA 0.69) are associated with significantly higher number of total CD34+ cells collected. These 2 regimens are also associated with significantly higher successful rate of achieving optimal target. There are no significant differences in rate of achieving optimal target between G-CSF SD + Plerixafor SD and G-CSF + YF-H-2015005. Conclusions In conclusion, ID-AraC plus G-CSF is associated with the highest probability of being best mobilization regimen in patients with MM. For patients with NHL, G-CSF in combination with plerixafor or YF-H-2015005 showed similar improvements in HSCs mobilization efficacy. The relative effects of other chemotherapy-based mobilization regimens still require to be determined with further investigations.

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“…Myeloma patients received G-CSF and a non-myelosuppressive mobilization chemotherapy with either vinorelbine or, in patients with preexisting neuropathy, gemcitabine. 1,[8][9][10] In few patients, only G-CSF was used (Table S1). Plerixafor was administered in poorly mobilizing patients, who failed to achieve a level of 10 0 000/ml CD34+ cells in the peripheral blood at the day before the planned apheresis procedure.…”

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confidence: 99%

Long‐term safety of the stem cell releasing compound plerixafor for peripheral stem cell collection in myeloma patients

Maechler

Bacher

Daskalakis

et al. 2022

Hematological Oncology

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A randomized evaluation of vinorelbine versus gemcitabine chemotherapy mobilization of stem cells in myeloma patients

Cited by 9 publications

References 13 publications

BeEAM Conditioning including High-Dose Bendamustine before Autologous Stem Cell Transplantation Is Safe and Effective in Patients with Waldenstrom’s Macroglobulinemia

BeEAM Conditioning including High-Dose Bendamustine before Autologous Stem Cell Transplantation Is Safe and Effective in Patients with Waldenstrom’s Macroglobulinemia

Efficacy of hematopoietic stem cell mobilization regimens in patients with hematological malignancies: a systematic review and network meta-analysis of randomized controlled trials

Long‐term safety of the stem cell releasing compound plerixafor for peripheral stem cell collection in myeloma patients

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