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Myeloma

Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma

Leukemia volume 21, pages 2035–2042 (2007)Cite this article

Abstract

While initial therapies have become highly effective with introduction of lenalidomide and bortezomib and patients may opt for delayed stem cell transplantation, it is important to collect stem cells for future transplant. Given its increasing use as initial therapy, we examined if lenalidomide had any impact on the ability to collect peripheral blood stem cells (PBSC). We studied the entire cohort of patients with myeloma undergoing PBSC mobilization at our institution during a 5-year period, comparing the results between patients receiving different initial therapies. Among those mobilized with granulocyte-colony stimulating factor (G-CSF) alone, there was a significant decrease in total CD34+ cells collected (P<0.001), average daily collection (P<0.001), day 1 collection (P<0.001) and increased number of aphereses (P=0.004) in patients treated with lenalidomide compared to those receiving dexamethasone, thalidomide-dexamethasone or VAD. A similar trend was seen in those mobilized with chemotherapy and G-CSF. A trend was seen towards decreased PBSC yield with increasing duration of lenalidomide therapy as well as increasing age (P=0.002). There was no effect on quality of PBSC collected based on similar engraftment across all groups. We recommend collection of PBSC within 6 months of initiation of therapy with lenalidomide containing regimens to minimize the risk of mobilization failures.

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Acknowledgements

This work is supported in part by Mayo Clinic Hematological Malignancies Program, Mayo Foundation CR20 program (SK), ASCO Career Development Award (SK).

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Authors and Affiliations

  1. Divisions of Hematology, Mayo Clinic, Rochester, MN, USA

    S Kumar, A Dispenzieri, M Q Lacy, S R Hayman, F K Buadi, D A Gastineau, M R Litzow, S V Rajkumar & M A Gertz

  2. Divisions of Hematology, Mayo Clinic, Scottsdale, AZ, USA

    R Fonseca

  3. Divisions of Hematology, Mayo Clinic, Jacksonville, FL, USA

    V Roy

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  1. S Kumar
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Correspondence to S Kumar.

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Kumar, S., Dispenzieri, A., Lacy, M. et al. Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma. Leukemia 21, 2035–2042 (2007). https://doi.org/10.1038/sj.leu.2404801

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