Stem cell mobilization with cyclophosphamide overcomes the suppressive effect of lenalidomide therapy on stem cell collection in multiple myeloma

Biol Blood Marrow Transplant. 2008 Jul;14(7):795-8. doi: 10.1016/j.bbmt.2008.04.008.

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

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antigens, CD34 / drug effects
  • Antineoplastic Combined Chemotherapy Protocols*
  • Clarithromycin / administration & dosage
  • Cyclophosphamide / therapeutic use*
  • Dexamethasone / administration & dosage
  • Drug Therapy, Combination
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematinics / therapeutic use*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Lenalidomide
  • Male
  • Middle Aged
  • Multiple Myeloma / therapy*
  • Remission Induction / methods
  • Stem Cells / drug effects
  • Thalidomide / administration & dosage
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives*
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Antigens, CD34
  • Hematinics
  • Granulocyte Colony-Stimulating Factor
  • Thalidomide
  • Dexamethasone
  • Cyclophosphamide
  • Lenalidomide
  • Clarithromycin