title: Phase 2 trial of intravenously administered plerixafor for stem cell mobilization in patients with multiple myeloma following lenalidomide-based initial therapy.
abstract: Initial therapy of multiple myeloma with lenalidomide-based regimens can compromise stem cell collection, which can be overcome with the addition of plerixafor. Plerixafor is typically given subcutaneously (SQ), with collection ∼11 h later for maximum yield. Intravenous administration may allow more rapid and predictable mobilization. This trial was designed to assess the efficacy and feasibility of IV plerixafor in patients receiving initial therapy with a lenalidomide-based regimen. Patients received G-CSF at 10 μg/kg/day for 4 days followed by IV plerixafor at 0.24 mg/kg/dose starting on day 5; plerixafor was administered early in the morning with apheresis 4-5 h later. Thirty-eight (97%) patients collected at least 3 × 10(6) CD34+ cells/kg within 2 days of apheresis. The median CD34+ cells/kg after 1 day of collection was 3.9 × 10(6) (range: 0.7-9.2) and after 2 days of collection was 6.99 × 10(6) (range: 1.1-16.5). There were no grade 3 or 4 non-hematological adverse events, and one patient experienced grade 4 thrombocytopenia. The most common adverse events were nausea, diarrhea and abdominal bloating. IV plerixafor is an effective strategy for mobilization with low failure rate and is well tolerated. It offers flexibility with a schedule of early-morning infusion followed by apheresis later in the day.
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Kumar
authors.affiliation: Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mikhael
authors.affiliation: Division of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: B
authors.initials: B
authors.lastname: Laplant
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: M Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: F K
authors.initials: FK
authors.lastname: Buadi
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dingli
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Gertz
authors.affiliation: Division of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: K
authors.initials: K
authors.lastname: Laumann
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: T
authors.initials: T
authors.lastname: Miceli
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Mahlman
authors.affiliation: Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: L P
authors.initials: LP
authors.lastname: Bergsagel
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Hayman
authors.affiliation: Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: C
authors.initials: C
authors.lastname: Reeder
authors.affiliation: Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Stewart
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: A
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: Division of Hematology, Blood and Marrow Transplantation, Mayo Clinic, Rochester, MN, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Gastineau
authors.affiliation: Division of Transfusion Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Winters
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; D013792:Thalidomide; D000077269:Lenalidomide; C088327:plerixafor