Results from a multicenter, noninterventional registry study for multiple myeloma patients who received stem cell mobilization regimens with and without plerixafor

Morris, Curly; Chabannon, Christian; Masszi, Tamás; Russell, Nigel H.; Nahi, Hareth; Kobbe, Guido; Krejčí, Marta; Auner, Holger W.; Pohlreich, David; Hayden, Patrick; Basak, Grzegorz W.; Lenhoff, Stig; Biezen, Anja van; Knol, Cora; Iacobelli, Simona; Liu, Qianying; Celanovic, Marina; Garderet, Laurent

doi:10.1038/s41409-019-0676-0

Cited by 14 publications

(12 citation statements)

References 30 publications

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“…The impact of Plerixafor on transplant outcomes is difficult to evaluate, due to the confounding factor that those receiving Plerixafor are largely poor mobilizers and therefore more likely to have poorer OS and PFS [17]. In studies selecting for predicted or proven poor mobilizers, Plerixafor use has been shown not to affect transplant outcomes [17, 18] suggesting there is not an advantage to using G‐CSF + Plerixafor over Cyclo‐G. Conversely, mobilization using cyclophosphamide incurs risk associated with the use of alkylating agents; namely febrile neutropenia and increased episodes of hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

“…The negligible impact of Cyclo‐G versus G‐CSF mobilization on subsequent neutrophil engraftment has been previously reported in the literature [16]. The impact of Plerixafor on transplant outcomes is difficult to evaluate, due to the confounding factor that those receiving Plerixafor are largely poor mobilizers and therefore more likely to have poorer OS and PFS [17]. In studies selecting for predicted or proven poor mobilizers, Plerixafor use has been shown not to affect transplant outcomes [17, 18] suggesting there is not an advantage to using G‐CSF + Plerixafor over Cyclo‐G.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of peripheral blood stem cell collection outcomes for multiple myeloma; mobilization matters in the era of IMiD induction

Chandler

Parrish

Καρακάντζα

et al. 2023

eJHaem

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Collection of peripheral blood stem cells (PBSCs) for autologous stem cell transplant (ASCT) requires mobilization from the bone marrow. There is variation in mobilization choice; during the COVID‐19 pandemic BSBMT&CT guidelines recommended using granulocyte‐colony stimulating factor (G‐CSF) alone to minimize the use of chemotherapy. We report on the impact of mobilization regimen on stem cell collection, and whether IMiD‐containing induction therapy impacts on mobilization and consequently transplant engraftment times for 83 patients undergoing ASCT at Leeds Teaching Hospitals.Cyclophosphamide plus G‐CSF (cyclo‐G) mobilization yielded more CD34+ cells (8.94 vs. 4.88 ×106/kg, p = < 0.0001) over fewer days (1.6 vs. 2.4 days, p = 0.007), and required fewer doses of salvage Plerixafor than G‐CSF only (13.6% vs. 35%, p = 0.0407). IMiD‐containing induction impaired all of these factors. CD34+ doses > 8×106/kg were more frequent with Cyclo‐G (62% vs. 11%, p = 0.0001), including for those receiving IMiD 1st line induction (50% vs. 13.3%, p = 0.0381). Note that 92.6% of those receiving IMiD‐free inductions were mobilized with Cyclo‐G.The novel agents used in modern induction regimens (e.g Daratumumab) have been shown to impair yields, increasing the importance of optimizing mobilization regimens in the first instance. Furthermore, as cellular therapies become established in the management of multiple myeloma emerging data highlights the potential benefits of stem cell top up in the management of the haematological toxicities of these therapies. Our findings support re‐adoption of Cyclo‐G as the gold standard for mobilization to optimize PBSC harvesting and ensure sufficient cells for subsequent ASCTs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparison of peripheral blood stem cell collection outcomes for multiple myeloma; mobilization matters in the era of IMiD induction

Chandler

Parrish

Καρακάντζα

et al. 2023

eJHaem

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“…We included all consecutive patients with MM from the CALM study who underwent ≥1 ASCT in this cohort between 2008 and 2012. The primary outcomes of the study were previously published [ 1 , 2 ]. Here, we report the analysis of the data collected in the CALM study.…”

Section: Methodsmentioning

confidence: 99%

Complications of Autologous Stem Cell Transplantation in Multiple Myeloma: Results from the CALM Study

Waszczuk‐Gajda

Penack

Sbianchi

et al. 2022

JCM

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Background: The main goal of this post hoc analysis of the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study was to evaluate the rate of short- and long-term infectious and non-infectious complications occurring after ASCT in patients with multiple myeloma (MM). Methods: The analysis included all patients with MM from the CALM study who underwent ≥1 ASCT. The primary endpoint of the analysis was to determine the rate of infectious and non-infectious complications after ASCT and to compare them in three time periods: 0–100 days, 101 days–1 year, and >1 year after the first transplant. Results: The analysis included a total of 3552 patients followed up for a median of 56.7 months (range 0.4–108.1). Complication rates decreased with the time from ASCT with 24.85 cases per 100 patient-years from day 0 to 100 days after the transplant, and <2.31 cases per 100 patient-years from the 101st day. At 100 days after ASC T, 45.7% of patients had complications, with infectious events being twice as frequent as non-infectious complications. Bacterial infections (6.5 cases per 100 patient-years, 95% CI: 6.1–7.0) and gastrointestinal complications (4.7 cases per 100 patient-years, 95% CI: 4.3–5.1) were the most common early events. The pattern of complications changed with time from ASCT. The presence of complications after ASCT was not associated with overall survival. Conclusions: Our data provide a solid basis for comparing ASCT-related complications to those caused by emerging treatments in multiple myeloma, such as CAR T-cell therapy and other immunotherapies.

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“…Furthermore, the possibility of tumor cell contamination of plerixaformobilized HPCs cannot be completely ruled out 6,7 . In fact, Morris et al reported that the cumulative incidence of relapse after transplantation was higher in the plerixafor cohort than in the other regimen cohorts 8 .…”

Section: Introductionmentioning

confidence: 96%

A Novel Hematopoietic Progenitor Cell Mobilization Regimen Comprising Bortezomib, G-CSF, and Preemptive Plerixafor for Multiple Myeloma

2020

BCT

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Adequate hematopoietic progenitor cell collection is critical for autologous peripheral blood stem cell transplantation. Conventionally, patients with multiple myeloma are treated with high-dose cyclophosphamide and granulocyte colony-stimulating factor(G-CSF)or G-CSF alone to mobilize their peripheral blood stem cells. However, some patients exhibit insufficient stem cell recruitment in response to these regimens. Recently, plerixafor has been approved for coverage by insurance in Japan. Combination treatment with plerixafor and G-CSF is now a standard procedure. In addition, treatment with bortezomib and G-CSF results in efficient stem cell recruitment. On the basis of the results from mouse studies, we hypothesized that combination treatment with bortezomib ensures efficient mobilization and mediates in vivo purging of malignant cells. Therefore, we administered a regimen of bortezomib, G-CSF, and preemptive plerixafor to 10 patients with multiple myeloma, and analyzed its efficacy and safety. The median patient age was 68 years. We collected CD34-positive cells(median: 4.9×10 6 ／kg)in a single session of apheresis from all patients. We observed no obvious myeloma cell contamination in the collected product or serious toxicity during treatment and collection. After collection, we performed autologous peripheral blood stem cell transplantation and confirmed engraftment in all patients (median: day 10) . We found that the regimen is safe and reliably facilitated the collection of sufficient autologous peripheral blood stem cells by apheresis from all patients in a single day. Despite the small patient group size, we conclude that the regimen is promising for safe and efficient collection of peripheral blood stem cells for autologous transplantation in patients with multiple myeloma.

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Results from a multicenter, noninterventional registry study for multiple myeloma patients who received stem cell mobilization regimens with and without plerixafor

Cited by 14 publications

References 30 publications

A comparison of peripheral blood stem cell collection outcomes for multiple myeloma; mobilization matters in the era of IMiD induction

A comparison of peripheral blood stem cell collection outcomes for multiple myeloma; mobilization matters in the era of IMiD induction

Complications of Autologous Stem Cell Transplantation in Multiple Myeloma: Results from the CALM Study

A Novel Hematopoietic Progenitor Cell Mobilization Regimen Comprising Bortezomib, G-CSF, and Preemptive Plerixafor for Multiple Myeloma

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