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.
Mark
Tomer
T
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.
Stern
Jessica
J
Furst
Jessica R
JR
Jayabalan
David
D
Zafar
Faiza
F
LaRow
April
A
Pearse
Roger N
RN
Harpel
John
J
Shore
Tsiporah
T
Schuster
Michael W
MW
Leonard
John P
JP
Christos
Paul J
PJ
Coleman
Morton
M
Niesvizky
Ruben
R
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