title: A novel hematopoietic progenitor cell mobilization regimen, utilizing bortezomib and filgrastim, for patients undergoing autologous transplant.
abstract: Adequate hematopoietic progenitor cell (HPC) collection is critical for patients undergoing autologous HPC transplant (AHPCT). Historically, 15 - 30% of patients failed HPC mobilization with granulocyte-colony stimulating factor (G-CSF) alone. Bortezomib, a proteasome inhibitor, has been shown to down regulate very late antigen-4 (VLA-4), an adhesion molecule expressed on HPCs. In this pilot study, bortezomib was administered on days -11 and -8 at a dose of 1.3 mg/m2intravenously (IV) or subcutaneously (SQ), followed by G-CSF 10 mcg/kg SQ, on days -4 to -1 prior to HPC collection (Day 1). Nineteen patients, with multiple myeloma (n = 12) or non-Hodgkin lymphoma (n = 7) undergoing AHPCT for the first time, were enrolled. Patients were excluded if they had worse than grade II neuropathy or platelet count less than 100 x 109/L. Bortezomib was well tolerated and all patients had adequate HPC collections with no mobilization failures. One patient (6%) had a CD34+cell count of 3.9 cells/µL on Day 1 and received plerixafor per institutional algorithm. Eleven patients completed HPC collection in 1 day and eight in 2 days. All patients underwent AHPCT and had timely neutrophil and platelet engraftment. Comparison with a historical control group of 70 MM and lymphoma patients, who were mobilized with G-CSF, showed significantly higher CD 34+ cells/kg collected in the bortezomib mobilization study group. Bortezomib plus G-CSF is an effective HPC mobilizing regimen worth investigating further in subsequent studies. J. Clin. Apheresis 31:559-563, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Medicine, the University of Kansas Hospital, Blood and Marrow Transplant, Kansas City, Kansas.
authors.forename: Sunil
authors.initials: S
authors.lastname: Abhyankar
authors.affiliation: Department of Pharmacy, the University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Philip
authors.initials: P
authors.lastname: Lubanski
authors.affiliation: Apheresis and Cell Processing, the University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Shaun
authors.initials: S
authors.lastname: DeJarnette
authors.affiliation: Apheresis and Cell Processing, the University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Dean
authors.initials: D
authors.lastname: Merkel
authors.affiliation: Clinical Trials Office, the University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bunch
authors.affiliation: Clinical Trials Office, the University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Kelly
authors.initials: K
authors.lastname: Daniels
authors.affiliation: Department of Medicine, the University of Kansas Hospital, Blood and Marrow Transplant, Kansas City, Kansas.
authors.forename: Omar
authors.initials: O
authors.lastname: Aljitawi
authors.affiliation: Department of Medicine, the University of Kansas Hospital, Blood and Marrow Transplant, Kansas City, Kansas.
authors.forename: Tara
authors.initials: T
authors.lastname: Lin
authors.affiliation: Department of Medicine, the University of Kansas Hospital, Blood and Marrow Transplant, Kansas City, Kansas.
authors.forename: Sid
authors.initials: S
authors.lastname: Ganguly
authors.affiliation: Department of Medicine, the University of Kansas Hospital, Blood and Marrow Transplant, Kansas City, Kansas.
authors.forename: Joseph
authors.initials: J
authors.lastname: McGuirk
mesh_terms: D018952:Antigens, CD34 / Q000097:blood; D000069286:Bortezomib / Q000008:administration & dosage / Q000494:pharmacology*; D000069585:Filgrastim / Q000008:administration & dosage / Q000494:pharmacology*; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods* / Q000592:standards; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D065386:Historically Controlled Study; D014182:Transplantation, Autologous / Q000379:methods
chemical_list: D018952:Antigens, CD34; D000069286:Bortezomib; D000069585:Filgrastim
keywords: bortezomib; hematopoietic; lymphoma; mobilization; myeloma; transplant