title: Successful mobilization of PBSCs predicts favorable outcomes in multiple myeloma patients treated with novel agents and autologous transplantation.
abstract: Incorporation of novel agents into auto-SCT for patients with multiple myeloma has led to improvement in their outcomes. However, the effects of new drugs, either single or combined, on PBSC mobilization have not been fully evaluated, particularly in phase 3 clinical studies. We analyzed the impact of two novel agent-based induction treatments in patients enrolled in the GIMEMA MMY-3006 study comparing bortezomib, thalidomide and dexamethasone (VTD) versus thalidomide and dexamethasone (TD) in preparation for double auto-SCT. Results showed that a short-term induction therapy with VTD did not adversely affect CD34(+) cell yields as compared with TD (9.75 vs 10.76 × 10(6) CD34(+) cells/kg, P=0.220). For poor mobilizers (<4 × 10(6) CD34(+) cells/kg), 5-year rates of time to progression (TTP), progression-free survival (PFS) and overall survival (OS) were significantly shorter than for successful mobilizers (TTP:17 vs 48%, P<0.0001; PFS: 16 vs 46%, P<0.0001; OS: 50 vs 80%, P<0.0001). These differences were retained across patients randomized to the TD arm; conversely, no differences in outcomes were seen in patients treated with VTD, irrespective of the number of harvested CD34(+) cells. The number of collected PBSCs predicted better outcomes after auto-SCT and VTD overcame the negative impact of a poor stem cell mobilization.
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: A
authors: A
authors: Brioli
authors: Hematology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors: G
authors: G
authors: Perrone
authors: Department of Hematology, Stem Cell Transplant Unit, DISM, University Hospital, Udine, Italy.
authors: F
authors: F
authors: Patriarca
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: A
authors: A
authors: Pezzi
authors: Hematology Unit, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy.
authors: F
authors: F
authors: Nobile
authors: Department of Hematology and Oncology, IRCCS AOU San Martino-IST, Genova, Italy.
authors: F
authors: F
authors: Ballerini
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: M R
authors: MR
authors: Motta
authors: Department of Hematology, Istituto Scientifico Romagnolo per Studio e Cura dei Tumori, Meldola, Italy.
authors: S
authors: S
authors: Ronconi
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: P
authors: P
authors: Tacchetti
authors: Divisione di Ematologia, Università Federico II, Napoli, Italy.
authors: L
authors: L
authors: Catalano
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: B A
authors: BA
authors: Zannetti
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: S
authors: S
authors: Rizzi
authors: Division of Onco-Hematology, S.G. Moscati Hospital, Avellino, Italy.
authors: S
authors: S
authors: Volpe
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: E
authors: E
authors: Zamagni
authors: Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Perugia, Struttura Complessa Oncoematologia con autotrapianto, Azienda Ospedaliera Santa Maria, Terni, Italy.
authors: A M
authors: AM
authors: Liberati
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: K
authors: K
authors: Mancuso
authors: Division of Hematology, University of Torino, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy.
authors: M
authors: M
authors: Boccadoro
authors: Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: F E
authors: FE
authors: Davies
authors: Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: G J
authors: GJ
authors: Morgan
authors: Division of Hematology, University of Torino, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy.
authors: A
authors: A
authors: Palumbo
authors: Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
authors: M
authors: M
authors: Cavo
mesh_terms: D064592:Autografts; D000069286:Bortezomib / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D013792:Thalidomide / Q000008:administration & dosage*
chemical_list: D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone
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