Successful mobilization of peripheral blood stem cells with bortezomib + high-dose cyclophosphamide + G-CSF in a light chain myeloma patient after failure with Total Therapy 2

Abstract

Autologous stem cell transplantation is considered the best post-induction therapy for multiple myeloma (MM). Therefore, therapy for myeloma should be chosen not only on the basis of efficacy, but also taking into account their impact on the hematopoietic stem cell compartment. We describe the case of a MM patient in which a successful mobilization of peripheral stem cells was obtained with bortezomib, cyclophosphamide and G-CSF, after two failed attempts in the framework of Total Therapy 2. The patient underwent an autologous transplantation, showing a rapid and complete post-transplant hematological recovery. Our experience suggests that bortezomib is an effective anti-myeloma agent without negative impact on stem cell mobilization, even in patients with a previous history of failed harvest.

New agents in HSC mobilization

“…Bortezomib (Velcade ® ) (Fig. 3), a proteasome inhibitor used in the treatment of MM, has been reported to mobilize HSPC when used alone or in combination with either AMD3100 or G-CSF in murine models [100] and has also undergone early clinical studies [101,102]. In addition, the non-steroidal anti-inflammatory drug (NSAID) meloxicam (Fig.…”

Personalizing Stem Cell Research and Therapy: The Arduous Road Ahead or Missed Opportunity?

“…In the case of hematopoietic replacement or reconstitution, autologous stem cell therapy has found the most success as the main therapy in several hematological disorders, such as multiple myeloma and malignant lymphoma [42, 43]. During autologous transplant, host stem cells are harvested and cryopreserved prior to chemotherapy treatment, then re-administered, preventing damage to the host stem cell pool [28, 42, 44].…”