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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Stem cell collection in patients with multiple myeloma: impact of induction therapy and mobilization regimen
1Hematologic Malignancies and Bone Marrow Transplant Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Abstract:
Lenalidomide is an active treatment for multiple myeloma (MM) and is increasingly used as part of the initial treatment of this disease. Recent reports have suggested decreases in the number of CD34+ cells collected and increases in the failure rate among patients whose initial therapy contained lenalidomide when mobilized with G-CSF alone. A retrospective data analysis of 364 patients with MM who underwent stem cell mobilization and attempted harvest at the Hospital of the University of Pennsylvania between January 2002 and December 2007 was performed. Forty-three of the patients received lenalidomide in their induction regimen, and were mobilized with either CY and G-CSF or G-CSF alone. The number of apheresis cycles and the failure rate were lower, whereas the mean number of collected stem cells was higher in patients who were mobilized with CY and G-CSF in comparison with G-CSF alone. This suggests that lenalidomide does not prevent the harvest of adequate numbers of CD34 cells for autologous stem cell transplant, but mobilization with G-CSF and CY may be required to obtain adequate numbers of stem cells. Finally, in our study, the number of lenalidomide cycles did not correlate with stem cell yield.
Insights
Lenalidomide treatment for multiple myeloma (MM) does not hinder stem cell collection. Combining cyclophosphamide (CY) with G-CSF for mobilization improves stem cell yield compared to G-CSF alone in MM patients.
Area of Science:
- Hematology
- Oncology
- Stem Cell Transplantation
Background:
- Lenalidomide is a key treatment for multiple myeloma (MM).
- Concerns exist regarding lenalidomide's impact on stem cell mobilization with G-CSF alone.
- Autologous stem cell transplantation is a crucial component of MM therapy.
Purpose of the Study:
- To evaluate the effect of lenalidomide-containing induction regimens on CD34+ cell collection.
- To compare stem cell mobilization strategies in multiple myeloma patients treated with lenalidomide.
- To determine if lenalidomide impacts the success of autologous stem cell harvest.
Main Methods:
- Retrospective analysis of 364 multiple myeloma patients undergoing stem cell mobilization and harvest.
- Data collected from January 2002 to December 2007.
- Comparison of mobilization with G-CSF alone versus cyclophosphamide (CY) and G-CSF in 43 patients who received lenalidomide.
Main Results:
- Mobilization with CY and G-CSF resulted in fewer apheresis cycles and lower failure rates compared to G-CSF alone.
- Patients mobilized with CY and G-CSF achieved a higher mean number of collected CD34+ cells.
- The number of lenalidomide cycles did not correlate with stem cell yield in this study.
Conclusions:
- Lenalidomide in induction therapy does not preclude adequate CD34+ cell collection for autologous stem cell transplant.
- Mobilization with both G-CSF and CY is a more effective strategy for obtaining sufficient stem cells in lenalidomide-treated MM patients.
- This study suggests that combination mobilization is key for successful stem cell harvest in this patient population.
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