Management of multiple myeloma: The changing landscape

Reece, Donna

doi:10.1016/j.blre.2007.07.001

Cited by 23 publications

(25 citation statements)

References 85 publications

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“…Thalidomide, bortezomib, and lenalidomide are changing therapeutic paradigms in patients with multiple myeloma (1, 2). Used as salvage therapy, these agents have been highly effective in increasing response rates, event-free survival and overall survival when standard therapies have failed (3–13).…”

Section: Introductionmentioning

confidence: 99%

Impairment of Filgrastim-Induced Stem Cell Mobilization after Prior Lenalidomide in Patients with Multiple Myeloma

Popat

Saliba

Thandi

et al. 2009

Biology of Blood and Marrow Transplantation

159

146

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Lenalidomide is an agent that has shown great activity in patients with multiple myeloma. However, studies have suggested that this drug negatively affects subsequent stem cell collection. To investigate whether lenalidomide impairs stem cell mobilization and collection, we reviewed data for patients with multiple myeloma who underwent mobilization with filgrastim. Predictors of mobilization failure were evaluated using logistic regression analysis. In 26 (9%) of 302 myeloma patients, stem cell mobilization failed. Mobilization failed in 25% of patients who had previously received lenalidomide, compared with 4% of patients who had not received lenalidomide (P < .001). In a multivariate analysis, prior lenalidomide use (odds ratio, 5.9; 95% CI, 2.4 to 14.3) and mobilization more than 1 year after diagnosis (odds ratio, 4.6; 95% CI, 1.9 to 11.1) were significantly associated with failed mobilization. Twenty-one of 26 patients in whom mobilization with filgrastim failed underwent remobilization with chemotherapy and filgrastim; in 18 (86%) of these 21 patients, stem cells were successfully mobilized and collected. In patients with multiple myeloma, prior lenalidomide therapy is associated with failure of stem cell mobilization with filgrastim. Remobilization with chemotherapy and filgrastim is usually successful in these patients.

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Section: Introductionmentioning

confidence: 99%

Impairment of Filgrastim-Induced Stem Cell Mobilization after Prior Lenalidomide in Patients with Multiple Myeloma

Popat

Saliba

Thandi

et al. 2009

Biology of Blood and Marrow Transplantation

159

146

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“…Novel therapies include thalidomide, lenalidomide and bortezomib, which have been studied extensively in a relapsed setting as single agents, in combination with dexamethasone, and in combination with cytotoxic agents or with each other 6. Salvage chemotherapy regimens such as vincristine, doxorubicin and dexamethasone (VAD) can also be an option for relapsed disease, though they have largely been replaced by novel agents in the front-line setting.…”

Section: Introductionmentioning

confidence: 99%

Second auto-SCT is safe and effective salvage therapy for relapsed multiple myeloma

Olin

Vogl

Porter

et al. 2008

Bone Marrow Transplant

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Therapeutic options for patients with multiple myeloma whose disease has relapsed after a prior auto-SCT include novel biologic therapies, traditional chemotherapy or a second transplant, with no clear standard of care. Few published studies address the safety and efficacy of a second auto-SCT for relapsed disease. We reviewed the Abramson Cancer Center experience with salvage auto-SCT for relapsed multiple myeloma. Forty-one patients had received a salvage auto-SCT at our institution; the median time between transplants was 37 months (range 3-91). The overall response rate in assessable patients was 55%, and treatment-related mortality was 7%. With a median follow-up time of 15 months, the median PFS was 8.5 months and the median overall survival (OS) was 20.7 months. In a multivariate analysis of OS, independent prognostic factors were X5 prior lines of therapy and time to progression after initial auto-SCT of p12 months. We conclude that in well-selected patients, salvage auto-SCT is safe and effective for relapsed myeloma.

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“…This approach has resulted in higher response rates following induction therapy and auto-SCT. 2,3 Previous studies have determined that the optimal number of CD34 þ cells for a single auto-SCT is 4-6 Â 10 6 CD34 þ cells/kg, with deleterious effects on engraftment observed once the SC dose falls below 2 Â 10 6 CD34 þ cells/kg. 4,5 G-CSF with or without chemotherapy is considered the standard approach for SC mobilization.…”

Section: Introductionmentioning

confidence: 99%

“…6 Despite these advances in SC collection strategies, it is estimated that about 5% of patients with MM fail to mobilize sufficient SCs for auto-SCT. 3 Risk factors associated with poor SC yield and mobilization failure include age, exposure to alkylating agents such as melphalan, extensive radiation therapy, widespread BM infiltration and mobilization regimens. [7][8][9][10][11][12] With the increasing use of novel agents in the upfront setting, several reports have emerged raising concerns regarding their impact on the ability to adequately collect SCs.…”

Section: Introductionmentioning

confidence: 99%

Factors impacting stem cell mobilization failure rate and efficiency in multiple myeloma in the era of novel therapies: experience at Memorial Sloan Kettering Cancer Center

Pozotrigo

Adel

Landau

et al. 2013

Bone Marrow Transplant

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Management of multiple myeloma: The changing landscape

Cited by 23 publications

References 85 publications

Impairment of Filgrastim-Induced Stem Cell Mobilization after Prior Lenalidomide in Patients with Multiple Myeloma

Impairment of Filgrastim-Induced Stem Cell Mobilization after Prior Lenalidomide in Patients with Multiple Myeloma

Second auto-SCT is safe and effective salvage therapy for relapsed multiple myeloma

Factors impacting stem cell mobilization failure rate and efficiency in multiple myeloma in the era of novel therapies: experience at Memorial Sloan Kettering Cancer Center

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