Stem cell mobilization with cyclophosphamide overcomes the suppressive effect of lenalidomide therapy on stem cell collection in multiple myeloma.
A total of 28 treatment-naïve patients with stage II or III multiple myeloma (MM) were treated with the combination of clarithromycin, lenalidomide, and dexamethasone (BiRD). Stem cells were collected following granulocyte-colony stimulating factor (G-CSF) or cyclophosphamide (Cy) plus G-CSF mobilization at maximum response. Sufficient stem cells for 2 autologous stem cell transplants were collected from all patients mobilized with Cy plus G-CSF, versus 33% mobilized with G-CSF alone (P < .0001). The duration of prior lenalidomide therapy did not correlate with success of stem cell harvests (P = .91). In conclusion, Cy can be added to G-CSF for stem cell mobilization to successfully overcome the suppressive effect of prior treatment with lenalidomide.
Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital-Cornell Medical Center, New York, New York 10021, USA.
Tomer
T
Mark
Jessica
J
Stern
Jessica R
JR
Furst
David
D
Jayabalan
Faiza
F
Zafar
April
A
LaRow
Roger N
RN
Pearse
John
J
Harpel
Tsiporah
T
Shore
Michael W
MW
Schuster
John P
JP
Leonard
Paul J
PJ
Christos
Morton
M
Coleman
Ruben
R
Niesvizky
D000368:Aged; D018952:Antigens, CD34 / Q000187:drug effects; D000971:Antineoplastic Combined Chemotherapy Protocols; D017291:Clarithromycin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D012074:Remission Induction / Q000379:methods; D013234:Stem Cells / Q000187:drug effects; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018952:Antigens, CD34; D006397:Hematinics; D016179:Granulocyte Colony-Stimulating Factor; D013792:Thalidomide; D003907:Dexamethasone; D003520:Cyclophosphamide; D000077269:Lenalidomide; D017291:Clarithromycin