Stem cell mobilization with cyclophosphamide overcomes the suppressive effect of lenalidomide therapy on stem cell collection in multiple myeloma
Tomer Mark, Jessica Stern, Jessica R Furst, David Jayabalan, Faiza Zafar, April LaRow, Roger N Pearse, John Harpel, Tsiporah Shore, Michael W Schuster, John P Leonard, Paul J Christos, Morton Coleman, Ruben Niesvizky, Tomer Mark, Jessica Stern, Jessica R Furst, David Jayabalan, Faiza Zafar, April LaRow, Roger N Pearse, John Harpel, Tsiporah Shore, Michael W Schuster, John P Leonard, Paul J Christos, Morton Coleman, Ruben Niesvizky
Abstract
A total of 28 treatment-naïve patients with stage II or III multiple myeloma (MM) were treated with the combination of clarithromycin, lenalidomide, and dexamethasone (BiRD). Stem cells were collected following granulocyte-colony stimulating factor (G-CSF) or cyclophosphamide (Cy) plus G-CSF mobilization at maximum response. Sufficient stem cells for 2 autologous stem cell transplants were collected from all patients mobilized with Cy plus G-CSF, versus 33% mobilized with G-CSF alone (P < .0001). The duration of prior lenalidomide therapy did not correlate with success of stem cell harvests (P = .91). In conclusion, Cy can be added to G-CSF for stem cell mobilization to successfully overcome the suppressive effect of prior treatment with lenalidomide.
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Source: PubMed