scholarly journals Phase II Trial of Intravenously Administered AMD3100 (Plerixafor) for Stem Cell Mobilization in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation Following a Lenalidomide Based Initial Therapy

2012 ◽  
Vol 18 (2) ◽  
pp. S247
Author(s):  
S. Kumar ◽  
J. Mikhael ◽  
M. Lacy ◽  
B. LaPlant ◽  
F. Buadi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Initial Therapy ◽  
Stem Cell Mobilization ◽  
Cell Mobilization

Impact of Bendamustine Pretreatment on Stem Cell Mobilization and Autologous Stem Cell Transplantation in Patients with Multiple Myeloma

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1933-1933 ◽  
Author(s):  
Wolfram Pönisch ◽  
Julia Wiesler ◽  
Ina Wagner ◽  
Sabine Leiblein ◽  
Elvira Edel ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Peripheral Blood ◽  
Research Funding ◽  
Stem Cell Mobilization ◽  
Cross Resistance ◽  
Cell Mobilization

Abstract Abstract 1933 Introduction: Bendamustine is a bifunctional alkylating agent with low toxicity that produces both single- and double-strand breaks in DNA, and shows only partial cross resistance with other alkylating drugs. Treatment of patients with newly diagnosed multiple myeloma using Bendamustine and Prednisone in comparison to Melphalan and Prednisone results in superior complete response rate and prolonged time to treatment failure (Poenisch et al, Res Clin Oncol 132: 205–212;2006). So far, however, reliable information on stem cell toxicity and mobilization of stem cells for autologous stem cell transplantation (SCT) after Bendamustine therapy is missing. Material and Methods: A retrospective analysis of peripheral blood stem cell mobilization and autologous SCT was performed in 63 patients with multiple myeloma who had received Bendamustine pretreatment at the university Hospitals Leipzig and Heidelberg over a period of sixteen years. Patients had a median age of 59 (range, 31–72) years. The cumulative dosis of Bendamustine per patient ranged between 120 and 2400mg/qm and was administered during a median of three (range 1–10) cycles. The mobilization regimen consisted of Cyclophosphamide 4g/qm (n=41) or 7g/qm (n=4) and G-CSF (2×5ug/kg). Alternative regimens such as CAD, CED, TCED and others were also used in the remaining patients. Apheresis was started as soon as peripheral blood CD34+ counts exceeded 10×106/l with a harvest target of 4×106 CD34+/kg using 4 times the blood volume. The minimal accepted target was 2×106 CD34+/kg. Results: Stem cell mobilization and harvest was successful in 60 of the 63 patients (95 %). In 19 of 60 patients (32 %) a single apharesis was sufficient to reach the target. The median number of aphareses was two (range 1–7) and the median CD34+ cell-count/kg was 5.9 (range 1.7–20.4) x106. Information on autologous SCT is available from all 60 patients with successful harvest. Engraftment was successful in 59 of 60 patients. The median time to leucocytes count > l ×109/l was reached after 12 days and the time to untransfused platelet count of >50×109/l was 14 days. 54 patients (90%) responded after the autologous SCT with 6 CR, 4 nCR, 12 VGPR, and 32 PR. The event free survival at 36 months was 31 % and overall survival was 68 %. In conclusion, the stem cell mobilization and autologous SCT is feasible in multiple myeloma patients who have received Bendamustine pretreatment. Disclosures: Pönisch: Mundipharma: Honoraria, Research Funding. Niederwieser:Mundipharma: Research Funding.

scholarly journals Plerixafor in non-Hodgkin’s lymphoma and multiple myeloma patients undergoing autologous stem cell transplantation

2011 ◽  
pp. 67-73
Author(s):  
Jan S. Moreb
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Stem Cell Mobilization ◽  
Hodgkin's Lymphoma ◽  
Cell Dose ◽  
Cell Mobilization ◽  
Pbsc Mobilization

Autologous stem cell transplantation (ASCT) is the standard of care for multiple myeloma (MM) and relapsing non-Hodgkin’s lymphoma (NHL) patients. Peripheral blood stem cells (PBSC) have become the main source of grafts for ASCT due to several advantages over bone marrow grafts. Poor PBSC mobilization and inadequate collection of CD34+ cell dose for safe engraftment is a reality for significant proportion of these patients. For this review, we conducted a PubMed search using the titles plerixafor and AMD3100 as well as poor stem cell mobilization. English-language articles were selected and data were extracted with focus on clinical studies of PBSC mobilization in MM and NHL patients. We discuss predictors of poor PBSC mobilization, the impact of poor mobilization on ASCT outcomes, the available agents that have been routinely used to enhance mobilization to achieve optimal CD34+ cell dose, and the role of plerixafor, the first CXCR4 antagonist to be approved for stem cell mobilization. Studies have shown that plerixafor is effective and safe when given with G-CSF either upfront or as a rescue for patients with MM or NHL. Currently, more patients are getting transplanted because of plerixafor. The challenge now is how to use the drug in the most cost effective way. Several scenarios on how to use the drug in proven or predicted poor mobilizers are proposed in this manuscript; however, validation for some of these approaches is still needed.

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