Impact of lenalidomide‐based induction therapy on the mobilization of CD34<sup>+</sup> cells, blood graft cellular composition, and post‐transplant recovery in myeloma patients: a prospective multicenter study

Partanen, Anu; Valtola, Jaakko; Silvennoinen, Raija; Ropponen, Antti; Siitonen, Timo; Putkonen, Matti; Sankelo, Marja; Pelkonen, Jukka; Mäntymaa, Pentti; Varmavuo, Ville; Jantunen, Esa

doi:10.1111/trf.14220

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…The limitation of the present study is the small number of patients especially in the PEG group. In addition, LEN‐based induction was more common in the FIL group, and in line with the previous findings, 31,32 the total yield of collected graft was hampered by LEN exposure. However, all the study patients achieved acceptable total apheresis yields.…”

Section: Discussionsupporting

confidence: 89%

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

et al. 2021

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Background Scarce data exist on the impact of granulocyte‐colony stimulating factor (G‐CSF) type on the mobilizing capacity of CD34+ cells, graft cellular composition, and outcome in myeloma (MM) patients. Patients and Methods In this prospective multicenter study, 70 patients with MM received filgrastim (FIL) and 20 patients received pegfilgrastim (PEG) as a G‐CSF after low‐dose cyclophosphamide. Flow cytometry was used to analyze the mobilization of CD34+ cells and cellular composition of blood grafts, hematologic recovery, and survival after auto‐SCT according to the G‐CSF choice. Results The CD34+ cell yield of the first apheresis was higher in the FIL group (5.3 vs. 4.2 × 106/kg, p = .025). The better mobilizing capacity was observed in the FIL group especially after bortezomib‐based induction based on the higher first apheresis yield of CD34+ cells (7.5 vs. 4.4 × 106/kg, p = .001). The median CD19+ cell count (1.0 vs. 0.4 × 106/kg, p = .010) and the number of CD3+ T lymphocytes (43.1 vs. 31.8 × 106/kg, p = .122) in the infused graft were higher in the patients mobilized with FIL. Both early (day +15) (56 vs. 108 × 109/L, p = .002) and later platelet recovery at 6 months (191 vs. 226 × 109/L, p = .026) were faster in the PEG group. Conclusion G‐CSF type seems to impact on the mobilization capacity and cellular composition of infused graft and also platelet recovery post‐transplant. A randomized study might be warranted to verify the effects of G‐CSF choice in the mobilization field.

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Section: Discussionsupporting

confidence: 89%

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

et al. 2021

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“…This would lead to a lower LOS overall. A prior study by Partanen et al [16] showed that a lenalidomide-based induction therapy led to an increased population of CD8 + and NK cells during autologous stem cell collection. Although the data in autologous transplantation are limited, prior studies in allogeneic stem cell transplantation have demonstrated that a decreased NK cell population post-transplant is associated with a higher incidence of graft-versus-host disease and that infusions of activated NK cells decreased graft-versus-host disease in a murine model [17,18].…”

Section: Discussionmentioning

confidence: 99%

Autologous Stem Cell Transplantation for Multiple Myeloma: Growth Factor Matters

Chen

Pan

Tuazon

et al. 2019

Biology of Blood and Marrow Transplantation

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Engraftment syndrome (ES) is a known complication of autologous hematopoietic stem cell transplant during neutrophil recovery. There is a limited amount of data available comparing the incidence of ES with post-transplant granulocyte colony-stimulating factor versus granulocyte macrophage colony-stimulating factor (GM-CSF), specifically in patients with multiple myeloma. Our retrospective review of 156 patients at a single center showed that GM-CSF was associated with a higher incidence of ES compared with G-CSF (32% versus 8% of patients, P < .001) and that development of ES was associated with a 32.9% (P < .001) longer hospital stay. This suggests that the choice of growth factor could possibly contribute to the development of ES and the associated costs of increased medical care.

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“…[7][8][9] A recently published network meta-analysis has covered a similar subject, 10 but unfortunately it failed to gather information on lenalidomide, which is now available through the results of the Myeloma XI trial. 11,12 Lenalidomide has been associated with hematopoietic progenitor cell graft harvesting failure, 13 a fact that has hindered its use in transplant-eligible patients in the past. Newer harvesting approaches however had made it possible for these patients to undergo autologous transplantation, 14 mitigating these obstacles.…”

Section: Introductionmentioning

confidence: 99%

Frontline treatment for transplant‐eligible multiple myeloma: A 6474 patients network meta‐analysis

Sekine

Ziegelmann

Manica

et al. 2018

Hematological Oncology

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Autologous transplantation continues to be the cornerstone of younger and fit multiple myeloma patients. It is known that frontline induction therapy before transplantation can influence post-transplant results. Therefore, best frontline treatment for transplant-eligible patients should be based on best available evidence to guide therapy. Furthermore, until now due to data scarcity, it was not possible to thoroughly compare lenalidomide to other regimens in this setting. We performed a systematic review and network (mixed treatment comparison) meta-analysis of 21 clinical trial publications, enrolling 6474 patients and comparing 11 different treatment frontline setting regimens regarding survival, response, and safety outcomes. OS analysis showed superiority of CRD (cyclophosphamide-lenalidomide-dexamethasone) over TD-based (thalidomide-dexamethasone, HR = 0.76,0.62-0.90), VAD-based (HR = 0.71,0.52-0.90), and Z-Dex (idarubicin-dexamethasone, HR = 0.37,0.17-0.76) regimens. Concerning PFS, VTD (bortezomib-thalidomide-dexametasone) showed superior results when compared with TD-based (HR = 0.66,0.51-0.84), VAD-based (HR = 0.61,0.46-0.82), Z-Dex (HR = 0.42,0.22-0.78), and high dose dexamethasone (Dex, HR = 0.62,0.41-0.90) regimens. Bortezomib/thalidomide regimens were not superior to lenalidomide, considering these outcomes. Also, concerning complete and overall response, VTD ranked first among other regimens, showing clear superiority over thalidomide-only containing protocols. Safety outcome evaluated infectious, cardiac, gastrointestinal, neurological, thrombotic, and hematological grade 3 to 4 adverse events. Risk of thrombotic events was higher with TAD (thalidomide-doxorubicin-dexamethasone), neurological with PAD (bortezomib-doxorubicin-dexamethasone), infectious with Dex, hematological with Z-Dex, gastrointestinal with VTD, and cardiac with PAD regimens. Our study endorses current recommendations on combined immunomodulatory drugs and proteasome inhibitors frontline regimens (in triplets) in transplant-eligible multiple myeloma patients, but also formally demonstrates the favorable performance of lenalidomide in overall and progression-free survival, when compared with bortezomib/thalidomide protocols.

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Impact of lenalidomide‐based induction therapy on the mobilization of CD34⁺ cells, blood graft cellular composition, and post‐transplant recovery in myeloma patients: a prospective multicenter study

Cited by 10 publications

References 30 publications

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

Autologous Stem Cell Transplantation for Multiple Myeloma: Growth Factor Matters

Frontline treatment for transplant‐eligible multiple myeloma: A 6474 patients network meta‐analysis

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Impact of lenalidomide‐based induction therapy on the mobilization of CD34+ cells, blood graft cellular composition, and post‐transplant recovery in myeloma patients: a prospective multicenter study

Cited by 10 publications

References 30 publications

Comparison of CD34+ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

Comparison of CD34+ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

Autologous Stem Cell Transplantation for Multiple Myeloma: Growth Factor Matters

Frontline treatment for transplant‐eligible multiple myeloma: A 6474 patients network meta‐analysis

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Product

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Impact of lenalidomide‐based induction therapy on the mobilization of CD34⁺ cells, blood graft cellular composition, and post‐transplant recovery in myeloma patients: a prospective multicenter study

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study

Comparison of CD34⁺ cell mobilization, blood graft cellular composition, and post‐transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low‐dose cyclophosphamide: A prospective multicenter study