Plerixafor for autologous peripheral blood stem cell mobilization in patients previously treated with fludarabine or lenalidomide.

Abstract

Fludarabine and lenalidomide are essential drugs in the front-line treatment of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), respectively. Data suggests that fludarabine and lenalidomide therapy may have a deleterious effect on stem cell mobilization. In the European compassionate use program, 48 patients (median age 57 years) previously treated with fludarabine (median 5 cycles; range: 1-7 cycles) were given plerixafor plus granulocyte colony-stimulating factor (G-CSF) for remobilization following a primary mobilization attempt. The overall median number of CD34+ cells collected was 2.3 × 10(6)/kg (range: 0.3-13.4). The minimum required number of CD34+ cells (≥2.0 × 10(6)/kg) was collected from 58% of patients in a median of 2 days. Thirty-five patients (median age = 57 years) previously treated with lenalidomide (median 5 cycles; range: 1-10 cycles) were given plerixafor plus G-CSF for remobilization. The overall median number of CD34+ cells collected was 3.4 × 10(6)/kg (range: 1.1-14.8). The minimum required number of CD34+ cells (≥2.0 × 10(6) per kg) was collected from 69% of patients in a median of 2 days. In conclusion, salvage mobilization with plerixafor plus G-CSF is successful in the majority of patients with MM previously treated with lenalidomide. In fludarabine-exposed patients, only 58% of patients will achieve successful salvage mobilization with plerixafor plus G-CSF, suggesting the need for novel mobilization regimens algorithms in this subgroup of patients.

• Authors: Florent Malard, Nicolaus Kröger, Ian H Gabriel, Kai Hübel, Jane F Apperley, Grzegorz W Basak, Kenneth W Douglas, Catarina Geraldes, Ozren Jaksic, Zdenek Koristek, Francesco Lanza, Roberto Lemoli, Gabor Mikala, Dominik Selleslag, Nina Worel, Mohamad Mohty, Rafael F Duarte
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 18 Issue 2 Pg. 314-7 (Feb 2012) ISSN: 1523-6536 [Electronic] United States
• PMID: 22001752 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-HIV Agents
• Antigens, CD34
• Antineoplastic Agents
• Benzylamines
• Cyclams
• Heterocyclic Compounds
• Granulocyte Colony-Stimulating Factor
• Thalidomide
• Lenalidomide
• Vidarabine
• fludarabine
• plerixafor

Topics

• Adult
• Aged
• Anti-HIV Agents (administration & dosage, adverse effects)
• Antigens, CD34 (blood)
• Antineoplastic Agents (administration & dosage, adverse effects)
• Benzylamines
• Compassionate Use Trials
• Cyclams
• Female
• Granulocyte Colony-Stimulating Factor (administration & dosage, adverse effects)
• Hematopoietic Stem Cell Mobilization (methods)
• Heterocyclic Compounds (administration & dosage, adverse effects)
• Humans
• Lenalidomide
• Lymphoma, Non-Hodgkin (blood, therapy)
• Male
• Middle Aged
• Multiple Myeloma (blood, therapy)
• Peripheral Blood Stem Cell Transplantation
• Thalidomide (administration & dosage, adverse effects, analogs & derivatives)
• Time Factors
• Transplantation, Autologous
• Vidarabine (administration & dosage, adverse effects, analogs & derivatives)