title: Mobilization in myeloma revisited: IMWG consensus perspectives on stem cell collection following initial therapy with thalidomide-, lenalidomide-, or bortezomib-containing regimens.
abstract: The past decade has witnessed a paradigm shift in the initial treatment of multiple myeloma with the introduction of novel agents such as thalidomide, lenalidomide, and bortezomib, leading to improved outcomes. High-dose therapy and autologous stem cell transplantation remains an important therapeutic option for patients with multiple myeloma eligible for the procedure. Before the advent of the novel agents, patients underwent stem cell collection prior to significant alkylating agent exposure, given its potential deleterious effect on stem cell collection. With increasing use of the novel agents in the upfront setting, several reports have emerged raising concerns about their impact on the ability to collect stem cells. An expert panel of the International Myeloma Working Group (IMWG) was convened to examine the implications of these therapies on stem collection in patients with myeloma and to develop recommendations for addressing these issues. Here we summarize the currently available data and present our perspective on the problem and potential options to overcome this problem. Specifically, we recommend early mobilization of stem cells, preferably within the first 4 cycles of initial therapy, in patients treated with novel agents and encourage participation in clinical trials evaluating novel approaches to stem cell mobilization.
authors: Division of Hematology, Mayo Clinic, Rochester, MN 55906, USA. kumar.shaji@mayo.edu
authors: Shaji
authors: S
authors: Kumar
authors: Sergio
authors: S
authors: Giralt
authors: Edward A
authors: EA
authors: Stadtmauer
authors: Jean L
authors: JL
authors: Harousseau
authors: Antonio
authors: A
authors: Palumbo
authors: William
authors: W
authors: Bensinger
authors: Raymond L
authors: RL
authors: Comenzo
authors: Suzanne
authors: S
authors: Lentzsch
authors: Nikhil
authors: N
authors: Munshi
authors: Ruben
authors: R
authors: Niesvizky
authors: Jesus
authors: J
authors: San Miguel
authors: Heinz
authors: H
authors: Ludwig
authors: Leif
authors: L
authors: Bergsagel
authors: Joan
authors: J
authors: Blade
authors: Sagar
authors: S
authors: Lonial
authors: Kenneth C
authors: KC
authors: Anderson
authors: Patrizia
authors: P
authors: Tosi
authors: Pieter
authors: P
authors: Sonneveld
authors: Orhan
authors: O
authors: Sezer
authors: David
authors: D
authors: Vesole
authors: Michele
authors: M
authors: Cavo
authors: Hermann
authors: H
authors: Einsele
authors: Paul G
authors: PG
authors: Richardson
authors: Brian G M
authors: BG
authors: Durie
authors: S Vincent
authors: SV
authors: Rajkumar
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods; D003245:Consensus Statements as Topic; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077269:Lenalidomide; D008495:Medical Oncology / Q000379:methods*; D009101:Multiple Myeloma / Q000628:therapy*; D011719:Pyrazines / Q000627:therapeutic use*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D007166:Immunosuppressive Agents; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide