title: Impairment of filgrastim-induced stem cell mobilization after prior lenalidomide in patients with multiple myeloma.
abstract: Lenalidomide is an agent that has shown great activity in patients with multiple myeloma (MM). However, studies have suggested that this drug negatively affects subsequent stem cell collection. To investigate whether lenalidomide impairs stem cell mobilization and collection, we reviewed data for patients with MM who underwent mobilization with filgrastim. Predictors of mobilization failure were evaluated using logistic regression analysis. In 26 (9%) of 302 myeloma patients, stem cell mobilization failed. Mobilization failed in 25% of patients who had previously received lenalidomide, compared with 4% of patients who had not received lenalidomide (P < .001). In a multivariate analysis, prior lenalidomide use (odds ratio: 5.9; 95% confidence interval [CI]: 2.4-14.3) and mobilization more than 1 year after diagnosis (odds ratio: 4.6; 95% CI: 1.9-11.1) were significantly associated with failed mobilization. Twenty-one of 26 patients in whom mobilization with filgrastim failed underwent remobilization with chemotherapy and filgrastim; in 18 (86%) of these 21 patients, stem cells were successfully mobilized and collected. In patients with multiple myeloma, prior lenalidomide therapy is associated with failure of stem cell mobilization with filgrastim. Remobilization with chemotherapy and filgrastim is usually successful in these patients.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. upopat@mdanderson.org
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Rima
authors.initials: R
authors.lastname: Saliba
authors.forename: Rupinderjit
authors.initials: R
authors.lastname: Thandi
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Muzaffar
authors.initials: M
authors.lastname: Qazilbash
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shpall
authors.forename: John
authors.initials: J
authors.lastname: McMannis
authors.forename: Martin
authors.initials: M
authors.lastname: Körbling
authors.forename: Amin
authors.initials: A
authors.lastname: Alousi
authors.forename: Borje
authors.initials: B
authors.lastname: Andersson
authors.forename: Yago
authors.initials: Y
authors.lastname: Nieto
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.forename: Issa
authors.initials: I
authors.lastname: Khouri
authors.forename: Marcos
authors.initials: M
authors.lastname: de Lima
authors.forename: Donna
authors.initials: D
authors.lastname: Weber
authors.forename: Sheeba
authors.initials: S
authors.lastname: Thomas
authors.forename: Michael
authors.initials: M
authors.lastname: Wang
authors.forename: Roy
authors.initials: R
authors.lastname: Jones
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001596:Benzylamines; D001853:Bone Marrow / Q000187:drug effects*; D003131:Combined Modality Therapy; D000080027:Cyclams; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000494:pharmacology; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000494:pharmacology; D000077269:Lenalidomide; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012307:Risk Factors; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014182:Transplantation, Autologous; D017211:Treatment Failure; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D013792:Thalidomide; D014750:Vincristine; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D000077269:Lenalidomide; D000069585:Filgrastim; C088327:plerixafor; D007069:Ifosfamide