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. Caravita; P. Musto; M. T. Petrucci; M. Boccadoro; A. Palumbo

doi:10.1038/leu.2011.131

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 journal › Article › peer-review

46 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 language	English
Pages (from-to)	1627-1631
Number of pages	5
Journal	Leukemia
Volume	25
Issue number	10
DOIs	https://doi.org/10.1038/leu.2011.131
State	Published - Oct 2011
Externally published	Yes

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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10.1038/leu.2011.131

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Cavallo, F., Bringhen, S., Milone, G., Ben-Yehuda, D., Nagler, A., Calabrese, E., Cascavilla, N., Montefusco, V., Lupo, B., Liberati, A. M., Crippa, C., Rossini, F., Passera, R., Patriarca, F., Cafro, A. M., Omedè, P., Carella, A. M., Peccatori, J., Catalano, L., ... Palumbo, A. (2011). Stem cell mobilization in patients with newly diagnosed multiple myeloma after lenalidomide induction therapy. Leukemia, 25(10), 1627-1631. https://doi.org/10.1038/leu.2011.131

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title = "Stem cell mobilization in patients with newly diagnosed multiple myeloma after lenalidomide induction therapy",

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.",

keywords = "lenalidomide, mobilization, myeloma, novel agent, transplantation",

author = "F. Cavallo and S. Bringhen and G. Milone and D. Ben-Yehuda and A. Nagler and E. Calabrese and N. Cascavilla and V. Montefusco and B. Lupo and Liberati, {A. M.} and C. Crippa and F. Rossini and R. Passera and F. Patriarca and Cafro, {A. M.} and P. Omed{\`e} and Carella, {A. M.} and J. Peccatori and L. Catalano and T. Caravita and P. Musto and Petrucci, {M. T.} and M. Boccadoro and A. Palumbo",

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 Jos{\`e} 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.",

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month = oct,

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Cavallo, F, Bringhen, S, Milone, G, Ben-Yehuda, D, Nagler, A, Calabrese, E, Cascavilla, N, Montefusco, V, Lupo, B, Liberati, AM, Crippa, C, Rossini, F, Passera, R, Patriarca, F, Cafro, AM, Omedè, P, Carella, AM, Peccatori, J, Catalano, L, Caravita, T, Musto, P, Petrucci, MT, Boccadoro, M & Palumbo, A 2011, 'Stem cell mobilization in patients with newly diagnosed multiple myeloma after lenalidomide induction therapy', Leukemia, vol. 25, no. 10, pp. 1627-1631. https://doi.org/10.1038/leu.2011.131

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AU - Cavallo, F.

AU - Bringhen, S.

AU - Milone, G.

AU - Ben-Yehuda, D.

AU - Nagler, A.

AU - Calabrese, E.

AU - Cascavilla, N.

AU - Montefusco, V.

AU - Lupo, B.

AU - Liberati, A. M.

AU - Crippa, C.

AU - Rossini, F.

AU - Passera, R.

AU - Patriarca, F.

AU - Cafro, A. M.

AU - Omedè, P.

AU - Carella, A. M.

AU - Peccatori, J.

AU - Catalano, L.

AU - Caravita, T.

AU - Musto, P.

AU - Petrucci, M. T.

AU - Boccadoro, M.

AU - Palumbo, A.

N1 - 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.

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

Abstract

Bibliographical note

Keywords

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