title: Plerixafor for autologous peripheral blood stem cell mobilization in patients previously treated with fludarabine or lenalidomide.
abstract: Fludarabine and lenalidomide are essential drugs in the front-line treatment of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), respectively. Data suggests that fludarabine and lenalidomide therapy may have a deleterious effect on stem cell mobilization. In the European compassionate use program, 48 patients (median age 57 years) previously treated with fludarabine (median 5 cycles; range: 1-7 cycles) were given plerixafor plus granulocyte colony-stimulating factor (G-CSF) for remobilization following a primary mobilization attempt. The overall median number of CD34+ cells collected was 2.3 × 10(6)/kg (range: 0.3-13.4). The minimum required number of CD34+ cells (≥2.0 × 10(6)/kg) was collected from 58% of patients in a median of 2 days. Thirty-five patients (median age = 57 years) previously treated with lenalidomide (median 5 cycles; range: 1-10 cycles) were given plerixafor plus G-CSF for remobilization. The overall median number of CD34+ cells collected was 3.4 × 10(6)/kg (range: 1.1-14.8). The minimum required number of CD34+ cells (≥2.0 × 10(6) per kg) was collected from 69% of patients in a median of 2 days. In conclusion, salvage mobilization with plerixafor plus G-CSF is successful in the majority of patients with MM previously treated with lenalidomide. In fludarabine-exposed patients, only 58% of patients will achieve successful salvage mobilization with plerixafor plus G-CSF, suggesting the need for novel mobilization regimens algorithms in this subgroup of patients.
authors: Centre Hospitalier et Universitaire de Nantes, Service d'Hématologie Clinique, Nantes, Université de Nantes, Centre d'Investigation Clinique en Cancérologie (CI2C), INSERM CRNCA UMR 892, Nantes, France.
authors: Florent
authors: F
authors: Malard
authors: Nicolaus
authors: N
authors: Kröger
authors: Ian H
authors: IH
authors: Gabriel
authors: Kai
authors: K
authors: Hübel
authors: Jane F
authors: JF
authors: Apperley
authors: Grzegorz W
authors: GW
authors: Basak
authors: Kenneth W
authors: KW
authors: Douglas
authors: Catarina
authors: C
authors: Geraldes
authors: Ozren
authors: O
authors: Jaksic
authors: Zdenek
authors: Z
authors: Koristek
authors: Francesco
authors: F
authors: Lanza
authors: Roberto
authors: R
authors: Lemoli
authors: Gabor
authors: G
authors: Mikala
authors: Dominik
authors: D
authors: Selleslag
authors: Nina
authors: N
authors: Worel
authors: Mohamad
authors: M
authors: Mohty
authors: Rafael F
authors: RF
authors: Duarte
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018952:Antigens, CD34 / Q000097:blood; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001596:Benzylamines; D057176:Compassionate Use Trials; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D000077269:Lenalidomide; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D014182:Transplantation, Autologous; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D019380:Anti-HIV Agents; D018952:Antigens, CD34; D000970:Antineoplastic Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; D013792:Thalidomide; D000077269:Lenalidomide; D014740:Vidarabine; C024352:fludarabine; C088327:plerixafor