Stem cell mobilization in patients with newly diagnosed multiple myeloma after lenalidomide induction therapy

F. Cavallo, S. Bringhen, G. Milone, D. Ben-Yehuda, A. Nagler, E. Calabrese, N. Cascavilla, V. Montefusco, B. Lupo, A. M. Liberati, C. Crippa, F. Rossini, R. Passera, F. Patriarca, A. M. Cafro, P. Omedè, A. M. Carella, J. Peccatori, L. Catalano, T. CaravitaP. Musto, M. T. Petrucci, M. Boccadoro, A. Palumbo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Lenalidomide has raised concerns regarding its potential impact on the ability to collect stem cells for autologous stem cell transplantation, especially after prolonged exposure. The use of cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) to mobilize peripheral blood stem cells may overcome this concern. In newly diagnosed multiple myeloma (MM) patients, we investigated the influence of lenalidomide on stem cell collection. In a prospective study, 346 patients received four cycles of lenalidomide-dexamethasone (Rd). Stem cells were mobilized with cyclophosphamide and G-CSF. Patients failing to collect a minimum of 4 × 10 6 CD34 +/kg cells received a second mobilization course. After mobilization, a median yield of 8.7 × 10 6 CD34 +/kg was obtained from patients receiving Rd induction. After first mobilization, inadequate yield was observed in 21% of patients, whereas only 9% of patients failed to collect the target yield after the second mobilization attempt. In conclusion, we confirm that a short induction with lenalidomide allowed sufficient stem cells collection to perform autologous transplantation in 91% of newly diagnosed patients.

Original languageAmerican English
Pages (from-to)1627-1631
Number of pages5
JournalLeukemia
Volume25
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

Bibliographical note

Funding Information:
We thank the patients who agreed to participate in this study, the nurses, in particular Tiziana Zezza e Silvia Boscolo, and data managers Maria Josè Fornaro, Antonella Fiorillo, Federica Leotta and Debora Caldarazzo. The study RV MM PI 209 was funded by the Fondazione Neoplasie Sangue Onlus. Celgene supplied free Lenalidomide for the study RV MM PI 209. Celgene had no role in the study design, data analysis, data interpretation or writing of the report. We would like to acknowledge the editorial assistance of Anna Georgieva, MD, PhD, and Adriana Stan, PhD, with Excerpta Medica during the development of this publication.

Keywords

  • lenalidomide
  • mobilization
  • myeloma
  • novel agent
  • transplantation

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