title: Stem cell mobilization and autologous stem cell transplantation after pretreatment with bendamustine, prednisone and bortezomib (BPV) in newly diagnosed multiple myeloma.
abstract: BACKGROUND
  Reliable information on stem cell toxicity and mobilization of stem cells for autologous stem cell transplantation (SCT) after induction treatment with a combination of bendamustine, prednisone and bortezomib (BPV) is missing.
  
  
  METHODS
  A retrospective analysis of peripheral blood stem cell mobilization and autologous SCT was performed in 35 patients with MM who had received at least one cycle of a BPV-induction therapy consisting of bendamustine 60 mg/m(2) on days 1 and 2, bortezomib 1.3 mg/m(2) on days 1, 4, 8 and 11 and prednisone 100 mg on days 1, 2, 4, 8 and 11 between October 2008 and May 2014. The mobilization regimen consisted of cyclophosphamide 4 g/m(2) and G-CSF (2 × 5 μg/kg). Apheresis was started as soon as peripheral CD34(+) counts exceeded 20 × 10(6)/L with a harvest target of 8 × 10(6) CD34(+)/kg. The minimal accepted target was 2 × 10(6) CD34(+)/kg. The transplantation conditioning therapy consisted of melphalan 200 mg/m(2).
  
  
  RESULTS
  A median number of two (range 1-5) BPV cycles were given. The majority of patients (n = 31, 89 %) responded with two sCR, five nCR, 11 VGPR and 13 PR after BPV induction. Three patients had MR, and one SD. Stem cell mobilization and harvest were successful in all patients. In 19 of 35 patients (54 %), a single apheresis was sufficient to reach the target. The median number of aphereses was one (range 1-4), and the median CD34(+) cell-count/kg was 13.5 (range 3.2-33.1)  × 106. All patients received an autologous SCT. Engraftment was successful in 34 of 35 patients. The median time to a leukocyte count >l × 10(9)/L was 11 days, and the time to untransfused platelet count of >50 × 10(9)/L was 13 days. Thirty-four patients (97 %) responded after the autologous SCT with 11 sCR, two CR, seven nCR, seven VGPR and seven PR. The progression-free survival at 18 months was 87 %, and overall survival was 92 %.
  
  
  CONCLUSIONS
  Stem cell mobilization and autologous SCT are feasible in MM patients who have received BPV-induction therapy .
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany. Wolfram.poenisch@medizin.uni-leipzig.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Poenisch
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Madlen
authors.initials: M
authors.lastname: Plötze
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Holzvogt
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Andrea
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schliwa
authors.affiliation: Hospital Torgau, Christianistr. 1, 04860, Torgau, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zehrfeld
authors.affiliation: HELIOS Vogtland-Klinikum Plauen, Röntgenstraße 2, 08529, Plauen, Germany.
authors.forename: Doreen
authors.initials: D
authors.lastname: Hammerschmidt
authors.affiliation: Medical Care Center Schöneck, Albertplatz 1, 08261, Schöneck, Germany.
authors.forename: Maik
authors.initials: M
authors.lastname: Schwarz
authors.affiliation: Hematology Practise, Theodor-Heuss-Str. 2, 04435, Schkeuditz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Edelmann
authors.affiliation: Hematology Practise, Biedermannstr. 84, 04277, Leipzig, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Becker
authors.affiliation: Hematology Practise, Biedermannstr. 84, 04277, Leipzig, Germany.
authors.forename: Franz Albert
authors.initials: FA
authors.lastname: Hoffmann
authors.affiliation: Hematology Practise, Strümpellstr. 41, Dösen, 04289, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarzer
authors.affiliation: Heinrich-Braun-Hospital, Karl-Keil-Str. 35, 08060, Zwickau, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Kreibich
authors.affiliation: Carl-Thiem Klinikum Cottbus, Thiemstraße 111, 03048, Cottbus, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Gutsche
authors.affiliation: Hospital Zittau, Görlitzer Straße 10, 02763, Zittau, Germany.
authors.forename: Kolja
authors.initials: K
authors.lastname: Reifenrath
authors.affiliation: Georgius-Agricola Hospital Zeitz, Lindenallee 1, 06712, Zeitz, Germany.
authors.forename: Heidrun
authors.initials: H
authors.lastname: Schwarzbach
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Heyn
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Georg-Nikolaus
authors.initials: GN
authors.lastname: Franke
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Madlen
authors.initials: M
authors.lastname: Jentzsch
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Leiblein
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schwind
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Thoralf
authors.initials: T
authors.lastname: Lange
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Vladan
authors.initials: V
authors.lastname: Vucinic
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Haifa-Katrin
authors.initials: HK
authors.lastname: AlAli
authors.affiliation: Department of Hematology, University of Leipzig, Johannisallee 32a, 04103, Leipzig, Germany.
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000627:therapeutic use; D001781:Blood Component Removal; D000069286:Bortezomib / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous / Q000009:adverse effects
chemical_list: D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D000069286:Bortezomib; D000069461:Bendamustine Hydrochloride; D011241:Prednisone
keywords: Autologous stem cell transplantation; Bendamustine; Bortezomib; Newly diagnosed multiple myeloma; Stem cell mobilization