title: Role of plerixafor in autologous stem cell mobilization with vinorelbine chemotherapy and granulocyte-colony stimulating factor in patients with myeloma: a phase II study (PAV-trial).
abstract: Current practice in Switzerland for the mobilization of autologous stem cells in patients with myeloma is combining vinorelbine chemotherapy and granulocyte-colony stimulating factor (G-CSF) cytokine stimulation. We prospectively investigated adding intravenous plerixafor to the vinorelbine/G-CSF combination (VGP), and compared it with vinorelbine/plerixafor (VP) and G-CSF/plerixafor (GP) combinations. In a final cohort (VP-late), plerixafor was given on the first day of CD34 + cells increasing to > 15,000/mL peripheral blood. Four consecutive cohorts of 10 patients with myeloma were studied. We observed that intravenously administered plerixafor can be safely combined with vinorelbine/G-CSF. VGP was superior in mobilizing peripheral stem and progenitor cells compared to the three double combinations (VP, GP and VP-late), and GP mobilized better than VP. Our data indicate that the triple combination of VGP is an efficient strategy to collect autologous CD34 + cells, with G-CSF contributing predominantly in this concept. Plerixafor can be safely added to G-CSF and/or vinorelbine chemotherapy.
authors.affiliation: Department of Medical Oncology, Inselspital/University Hospital , Bern , Switzerland.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schmid
authors.forename: Dorothea
authors.initials: D
authors.lastname: Friess
authors.forename: Behrouz
authors.initials: B
authors.lastname: Mansouri Taleghani
authors.forename: Peter
authors.initials: P
authors.lastname: Keller
authors.forename: Beatrice U
authors.initials: BU
authors.lastname: Mueller
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Baerlocher
authors.forename: Kurt
authors.initials: K
authors.lastname: Leibundgut
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001596:Benzylamines; D000080027:Cyclams; D004357:Drug Synergism; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014747:Vinblastine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D019380:Anti-HIV Agents; D000972:Antineoplastic Agents, Phytogenic; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; D014747:Vinblastine; D000077235:Vinorelbine; C088327:plerixafor
keywords: Clinical results; myeloma; stem cell mobilization