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.
Publication types
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Clinical Trial, Phase II
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Antigens, CD34 / drug effects
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Antineoplastic Combined Chemotherapy Protocols*
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Clarithromycin / administration & dosage
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Cyclophosphamide / therapeutic use*
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Dexamethasone / administration & dosage
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Drug Therapy, Combination
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Female
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Granulocyte Colony-Stimulating Factor / therapeutic use
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Hematinics / therapeutic use*
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Hematopoietic Stem Cell Mobilization / methods*
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Hematopoietic Stem Cell Transplantation / methods*
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Humans
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Lenalidomide
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Male
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Middle Aged
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Multiple Myeloma / therapy*
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Remission Induction / methods
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Stem Cells / drug effects
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Thalidomide / administration & dosage
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Thalidomide / adverse effects
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Thalidomide / analogs & derivatives*
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Transplantation, Autologous
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Treatment Outcome
Substances
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Antigens, CD34
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Hematinics
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Granulocyte Colony-Stimulating Factor
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Thalidomide
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Dexamethasone
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Cyclophosphamide
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Lenalidomide
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Clarithromycin