Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience

Laurent, Vanille; Fronteau, Clémentine; Antier, C.; Dupuis, P; Tessoulin, Benoît; Gastinne, Thomas; Mahé, Béatrice; Blin, Nicolas; Dubruille, Viviane; Lok, Anne; Chevallier, Patrice; Guillaume, Thierry; Garnier, Alice; Péterlin, Pierre; Bourgeois, Amandine Le; Vantyghem, Sophie; Tiab, Mourad; Godmer, Pascal; Sadot, Sophie; Loirat, Marion; Trebouet, Adrien; Cormier, Nicolas; Gouill, Steven Le; Moreau, Philippe; Touzeau, Cyrille

doi:10.1038/s41409-020-01033-8

Cited by 12 publications

(7 citation statements)

References 26 publications

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“…In the phase 2 GRIFFIN study, daratumumab-VRD showed remarkable results [ 34 ]. However, Laurent et al [ 35 ] report on impaired PBSC collection after VRD versus VTD. One could thus speculate that Dara-VRD might lead to even lower PBSC yields compared to Dara-VTD.…”

Section: Discussionmentioning

confidence: 99%

Autologous Stem Cell Collection after Daratumumab, Bortezomib, Thalidomide, and Dexamethasone versus Bortezomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma

Sauer

Kriegsmann

Nientiedt

et al. 2023

Transfus Med Hemother

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Introduction: In transplant-eligible, newly diagnosed multiple myeloma (NDMM) patients, autologous peripheral blood stem cell (PBSC) collection is usually pursued after induction therapy. While induction regimens are constantly refined regarding response, their impact on PBSC collection is not fully studied. The inclusion of the anti-CD38 antibody daratumumab into induction therapy significantly improved outcomes for patients with NDMM, e.g., as part of the daratumumab, bortezomib, thalidomide, and dexamethasone (Dara-VTD) protocol. Preliminary data from the phase 3 CASSIOPEIA study proved the efficacy of Dara-VTD. While overall PBSC collection upon addition of daratumumab was reduced in the study population, more detailed analyses on the impact are missing. Methods: We here report on PBSC mobilization and collection metrics in n = 119 patients with NDMM who underwent induction therapy with bortezomib, cyclophosphamide, and dexamethasone (VCD, n = 61) or Dara-VTD (n = 58). Results: Patient characteristics were well balanced between groups. The Dara-VTD group showed improved response parameters with 66% of patients reaching at least very good partial response versus 54% in the VCD group. Dara-VTD patients exhibited inferior mobilization metrics such as peripheral blood CD34+ cell count at the first leukapheresis (LP) session (65 vs. 106/μL, p = 0.001), median number of LP sessions (2 vs. 1, p = 0.001), and PBSC collection at first LP (5.5 vs. 8.3 × 106/kg body weight [bw], p = 0.001). Utilization of plerixafor was slightly higher after Dara-VTD (33% vs. 21% of patients, p = 0.143). The overall PBSC collection result was significantly lower after Dara-VTD (8.4 vs. 9.6 × 106/kg bw, p = 0.026). 78% and 85% of patients successfully collected 3 transplants with ≥2 × 106 CD34+ cells/kg bw in the Dara-VTD and the VCD groups, respectively. Conclusion: In summary, Dara-VTD, possibly due to both anti-CD38 antibody and thalidomide exposure, imposes a limitation on PBSC collection which can be only partly overcome by utilization of plerixafor.

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Section: Discussionmentioning

confidence: 99%

Autologous Stem Cell Collection after Daratumumab, Bortezomib, Thalidomide, and Dexamethasone versus Bortezomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma

Sauer

Kriegsmann

Nientiedt

et al. 2023

Transfus Med Hemother

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“… 33 Other studies revealed that patients receiving fludarabine- and lenalidomide-based induction regimens required higher number of plerixafor administrations to achieve a successful mobilization. 34 , 35 To date novel drugs are used in induction therapy among patients with hematologic malignancies. Daratumumab, a novel monoclonal CD38 antibody, is increasingly administered to transplant-eligible newly diagnosed myeloma patients.…”

Section: Use Of Plerixafor For Autologous Sctmentioning

confidence: 99%

Use of Plerixafor for Stem Cell Mobilization in the Setting of Autologous and Allogeneic Stem Cell Transplantations: An Update

Bilgin¹

2021

JBM

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Mobilization failure is an important issue in stem cell transplantations. Stem cells are yielded from the peripheral blood via apheresis. Granulocyte colony-stimulating factor (G-CSF) is the most commonly used mobilization agent among patients and donors. G-CSF is administered subcutaneously for multiple days. However, patients with mobilization failure cannot receive autologous stem cell transplantation and, therefore, cannot be treated adequately. The incidence rate of mobilization failure among patients is about 6–23%. Plerixafor is a molecule that inhibits the binding of chemokine receptor-4 with stromal-cell-derived factor-1, thereby resulting in the release of CD34+ cells in the peripheral blood. Currently, plerixafor is used in patients with mobilization failure with G-CSF and is administered subcutaneously. Several studies conducted on different clinical settings have shown that plerixafor is effective and well tolerated by patients. However, more studies should be conducted to explore the optimal approach for plerixafor in patients with mobilization failure. The incidence of mobilization failure among donors is lower. However, plerixafor is not approved among donors with mobilization failure. Moreover, several clinical studies in donors have shown a beneficial effect of plerixafor. In addition, the adverse events of plerixafor are mild and transient, which can overcome the adverse events due to G-CSF. This review assessed the current role and effects of plerixafor in stem cell mobilization for autologous and allogeneic stem cell transplantations.

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“…A new open question is about the use of novel agents such as lenalidomide (R) and anti-CD38 immunotherapy (daratumumab) during the induction phase that may impact stem-cells collections. In a recent retrospective study of 325 patients with MM who received either VTD (velcade, thalidomide, and dexamethasone) or VRD induction before ASCT, in comparison with VTD, VRD induction was associated with more frequent use of plerixafor (19.3% versus 5.4%, p = 0.004), which is a CXC chemokine receptor 4 (CXCR4) antagonist that improves the release of stem cells from marrow into peripheral blood [59]. In another study, the analysis of MASTER and GRIFFIN trials showed that the use of daratumumab as induction therapy in MM patients determined a 2-fold increase in the use of plerixafor [60].…”

Section: Chemotherapy Mobilizationmentioning

confidence: 99%

Stem Cells Collection and Mobilization in Adult Autologous/Allogeneic Transplantation: Critical Points and Future Challenges

Prisciandaro,

Santinelli,

Tomarchio

et al. 2024

Cells

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Achieving successful hematopoietic stem cell transplantation (HSCT) relies on two fundamental pillars: effective mobilization and efficient collection through apheresis to attain the optimal graft dose. These cornerstones pave the way for enhanced patient outcomes. The primary challenges encountered by the clinical unit and collection facility within a transplant program encompass augmenting mobilization efficiency to optimize the harvest of target cell populations, implementing robust monitoring and predictive strategies for mobilization, streamlining the apheresis procedure to minimize collection duration while ensuring adequate yield, prioritizing patient comfort by reducing the overall collection time, guaranteeing the quality and purity of stem cell products to optimize graft function and transplant success, and facilitating seamless coordination between diverse entities involved in the HSCT process. In this review, we aim to address key questions and provide insights into the critical aspects of mobilizing and collecting hematopoietic stem cells for transplantation purposes.

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Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience

Cited by 12 publications

References 26 publications

Autologous Stem Cell Collection after Daratumumab, Bortezomib, Thalidomide, and Dexamethasone versus Bortezomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma

Autologous Stem Cell Collection after Daratumumab, Bortezomib, Thalidomide, and Dexamethasone versus Bortezomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma

Use of Plerixafor for Stem Cell Mobilization in the Setting of Autologous and Allogeneic Stem Cell Transplantations: An Update

Stem Cells Collection and Mobilization in Adult Autologous/Allogeneic Transplantation: Critical Points and Future Challenges

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