International myeloma working group (IMWG) consensus statement and guidelines regarding the current status of stem cell collection and high-dose therapy for multiple myeloma and the role of plerixafor (AMD 3100)

Giralt, Sergío; Stadtmauer, Edward A.; Harousseau, Jean Luc; Palumbo, Antônio; Bensinger, William I.; Comenzo, Raymond L.; Kumar, Shaji; Munshi, Nikhil C.; Dispenzieri, Angela; Kyle, Robert A.; Merlini, Giampaolo; Miguel, Jesús San; Ludwig, Heinz; Hájek, Roman; Jagannath, Sundar; Bladé, Joan; Lonial, Sagar; Dimopoulos, Meletios A.; Einsele, Hermann; Barlogie, Bart; Anderson, Kenneth C.; Gertz, Morie A.; Attal, Michel; Tosi, Patrizia; Sonneveld, Pieter; Boccadoro, Mario; Morgan, G. W.; Sezer, Orhan; Mateos, María‐Victoria; Cavo, Michèle; Joshua, Douglas; Turesson, Ingemar; Chen, W; Shimizu, Kazuyuki; Powles, R; Richardson, Paul G.; Niesvizky, Rubén; Rajkumar, S. Vincent; Durie, BG

doi:10.1038/leu.2009.127

Cited by 212 publications

(177 citation statements)

References 53 publications

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“…Stem cell collection with granulocyte colony-stimulating factor (G-CSF) alone may be impaired when Rd is used as induction therapy [50]. Thus patients over the age of 65 and those who have received more that four cycles of Rd) stem cells must be mobilized with either cyclophosphamide plus G-CSF or with plerixafor [51,52]. All patients treated with Rd require antithrombosis prophylaxis.…”

Section: Risk-adapted Therapymentioning

confidence: 99%

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

2013

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Disease overviewMultiple myeloma accounts for approximately 10% of hematologic malignancies.DiagnosisThe diagnosis requires 10% or more clonal plasma cells on bone marrow examination or a biopsy proven plasmacytoma plus evidence of associated end‐organ damage. In addition, the presence of 60% or more clonal plasma cells in the marrow is also considered as myeloma regardless of the presence or absence of end‐organ damage.Risk stratificationIn the absence of concurrent trisomies, patients with 17p deletion, t(14;16), and t(14;20) are considered to have high‐risk myeloma. Patients with t(4;14) translocation are considered intermediate‐risk. All others are considered as standard‐risk.Risk‐adapted initial therapyStandard‐risk patients can be treated with lenalidomide plus low‐dose dexamethasone (Rd), or a bortezomib‐containing triplet such as bortezomib, cyclophosphamide, dexamethasone (VCD). Intermediate‐risk and high‐risk patients require a bortezomib‐based triplet regimen. In eligible patients, initial therapy is given for approximately 4 months followed by autologous stem cell transplantation (ASCT). Standard‐risk patients can opt for delayed ASCT if stem cells can be cryopreserved. In patients are not candidates for transplant, initial therapy is given for approximately 12–18 months.Maintenance therapyAfter initial therapy, lenalidomide maintenance is considered for standard‐risk patients who are not in very good partial response or better, while maintenance with a bortezomib‐based regimen should be considered in pateints with intermediate or high‐risk myeloma.Management of refractory diseasePatients with indolent relapse can be treated first with two‐drug or three‐drug combinations. Patients with more aggressive relapse often require therapy with a combination of multiple active agents. Am. J. Hematol. 88:225–235, 2013. © 2013 Wiley Periodicals, Inc.

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Section: Risk-adapted Therapymentioning

confidence: 99%

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

2013

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“…14 Consolidation with auto-SCT remains a standard of care for most patients under the age of 65-70 years. 15 Once patients relapse/ progress after auto-SCT, long-term prognosis is unfavourable. The findings of several small studies suggest that RIC allo-SCT is feasible in patients who have relapsed after auto-SCT and may result in prolonged remissions.…”

Section: Introductionmentioning

confidence: 99%

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation

Auner

Szydlo

Biezen

et al. 2013

Bone Marrow Transplant

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Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.

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“…3,4 AHPCT is now an integral part of standard care for PCM patients and is the most common indication for AHPCT in North America. 5 Greater numbers of PCM patients are surviving for longer periods and many are proceeding to AHPCT. Thereafter, practitioners evaluate AHPCT recipients for extended follow up periods for a variety of reasons, including consideration of post-transplant maintenance therapies.…”

Section: Introductionmentioning

confidence: 99%

Secondary MGUS after autologous hematopoietic progenitor cell transplantation in plasma cell myeloma: a matter of undetermined significance

Manson

Campagnaro

Balog

et al. 2011

Bone Marrow Transplant

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Plasma cell myeloma, characterized by clonally aberrant plasma cells that produce abnormal monoclonal Igs, is the most common indication for autologous hematopoietic progenitor cell transplantation (AHPCT) in North America. We observed appearance of new monoclonal gammopathies different from the original protein in the post-AHPCT setting and termed this condition 'secondary MGUS' (monoclonal gammopathy of undetermined significance). Hence, we performed a retrospective, single institution review of serum protein electrophoresis/immunofixation electrophoresis data in 92 AHPCT recipients from the period 2000 --2009. In all, 22 of 92 patients (24%) undergoing AHPCT met criteria for secondary MGUS. Contrary to previous studies, often referred to as 'abnormal protein banding,' we did not observe this condition as a favorable prognostic indicator in affected patients when compared with the control group (P ¼ 0.686). However, we did note that a subgroup of the study cohort who developed secondary MGUS after a prolonged latency (410 months) had an improved median OS compared with the remainder of the study cohort (75 months vs 41 months, P ¼ 0.005). As there have been significant advancements in understanding the pathobiology and clinical significance of MGUS, we believe that secondary MGUS merits dedication of resources for investigation to determine its true clinical relevance, prognostic value and pathophysiology.

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International myeloma working group (IMWG) consensus statement and guidelines regarding the current status of stem cell collection and high-dose therapy for multiple myeloma and the role of plerixafor (AMD 3100)

Cited by 212 publications

References 53 publications

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation

Secondary MGUS after autologous hematopoietic progenitor cell transplantation in plasma cell myeloma: a matter of undetermined significance

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