Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma

Kumar, Shaji; Dispenzieri, Angela; Lacy, Martha Q.; Hayman, Suzanne R.; Buadi, Francis K.; Gastineau, Dennis A.; Litzow, Mark R.; Fonseca, Rafaël; Roy, Vivek; Rajkumar, S. Vincent; Gertz, Morie A.

doi:10.1038/sj.leu.2404801

Cited by 337 publications

(304 citation statements)

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“…That is sometimes challenging in heavily pretreated patients, particularly those who previously received lenalidomide [4,35]. Moreover, some data demonstrated different mobilization of PBSCs and myeloma cells, with peak levels of myeloma cells occurring few days after CD34+ cells [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Bojanić

Dubravčić

Batinić

et al. 2011

Transfusion and Apheresis Science

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Section: Discussionmentioning

confidence: 99%

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Bojanić

Dubravčić

Batinić

et al. 2011

Transfusion and Apheresis Science

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“…Overall, the patients were characterized by features that are known to affect standard stem cell mobilization negatively, including advanced age, a diagnosis of NHL, previous radiotherapy, extensive treatment with chemotherapy, treatment with lenalidomide or purine analogues, previous autoSCT, or failure of at least one previous attempt at mobilization [7][8][9][10][11][12][13][14][15]. We observed that, despite these unfavorable characteristics, mobilization with plerixafor and G-CSF enabled the required number of stem cells to be collected in 67.5% of patients.…”

Section: Discussionmentioning

confidence: 99%

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

et al. 2011

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The introduction of plerixafor has enabled successful collection of stem cells in the majority of patients with lymphoma or myeloma in whom previous attempts at mobilization have failed. However, a proportion of patients have been shown to be resistant to this mobilization regimen. To identify the factors that impair stem cell mobilization and collection with plerixafor, we reviewed the data for 197 patients who had undergone mobilization with plerixafor and granulocyte-colony stimulating factor in Central Europe. Predictors of mobilization failure were evaluated using logistic regression analysis. Among the 197 patients mobilized, the target of 2.0 3 10 6 CD341 cells/kg was collected from 133 (67.5%). Our analysis revealed that previous treatment with lenalidomide, bortezomib, melphalan, radiotherapy, or autologous stem cell transplantation and regimen of plerixafor use in combination with chemotherapy had no significant effect on the efficiency of collection. In contrast, an age 65 years (odds ratio 0.331, 95% CI: 0.112-0.977, P < 0.05), a diagnosis of non-Hodgkin's lymphoma (odds ratio 0.277, 95% CI: 0.124-0.622, P < 0.01), and treatment with four chemotherapy regimens (odds ratio 0.366, 95% CI: 0.167-0.799, P < 0.05) were associated significantly with failed mobilization. The rate of successful mobilizations was decreased in patients treated with purine analogues (odds ratio 0.323, 95% CI: 0.096-1.094, P 5 0.07) but increased in female patients (odds ratio 1.961, CI: 0.943-4.080, P 5 0.07). Patients who are characterized by the above negative features could benefit potentially from further improvement in the mobilization strategy. Am. J. Hematol. 86:550-553, 2011. V

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“…Rd which combines lenalidomide with a lower dose of dexamethasone (40 mg once weekly) is an active regimen in newly diagnosed myeloma, and has less toxicity and better OS than lenalidomide plus high dose dexamethasone [49]. Stem cell collection with granulocyte colony-stimulating factor (G-CSF) alone may be impaired when Rd is used as induction therapy [50]. Thus patients over the age of 65 and those who have received more that four cycles of Rd) stem cells must be mobilized with either cyclophosphamide plus G-CSF or with plerixafor [51,52].…”

Section: Risk-adapted Therapymentioning

confidence: 99%

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

2013

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Disease overviewMultiple myeloma accounts for approximately 10% of hematologic malignancies.DiagnosisThe diagnosis requires 10% or more clonal plasma cells on bone marrow examination or a biopsy proven plasmacytoma plus evidence of associated end‐organ damage. In addition, the presence of 60% or more clonal plasma cells in the marrow is also considered as myeloma regardless of the presence or absence of end‐organ damage.Risk stratificationIn the absence of concurrent trisomies, patients with 17p deletion, t(14;16), and t(14;20) are considered to have high‐risk myeloma. Patients with t(4;14) translocation are considered intermediate‐risk. All others are considered as standard‐risk.Risk‐adapted initial therapyStandard‐risk patients can be treated with lenalidomide plus low‐dose dexamethasone (Rd), or a bortezomib‐containing triplet such as bortezomib, cyclophosphamide, dexamethasone (VCD). Intermediate‐risk and high‐risk patients require a bortezomib‐based triplet regimen. In eligible patients, initial therapy is given for approximately 4 months followed by autologous stem cell transplantation (ASCT). Standard‐risk patients can opt for delayed ASCT if stem cells can be cryopreserved. In patients are not candidates for transplant, initial therapy is given for approximately 12–18 months.Maintenance therapyAfter initial therapy, lenalidomide maintenance is considered for standard‐risk patients who are not in very good partial response or better, while maintenance with a bortezomib‐based regimen should be considered in pateints with intermediate or high‐risk myeloma.Management of refractory diseasePatients with indolent relapse can be treated first with two‐drug or three‐drug combinations. Patients with more aggressive relapse often require therapy with a combination of multiple active agents. Am. J. Hematol. 88:225–235, 2013. © 2013 Wiley Periodicals, Inc.

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Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma

Cited by 337 publications

References 28 publications

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Large volume leukapheresis: Efficacy and safety of processing patient’s total blood volume six times

Identification of prognostic factors for plerixafor‐based hematopoietic stem cell mobilization

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

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