Plerixafor for Autologous Peripheral Blood Stem Cell Mobilization in Patients Previously Treated with Fludarabine or Lenalidomide

Florent Malard, Nicolaus Kröger, Ian H. Gabriel, Kai Hübel, Jane F. Apperley, Grzegorz W. Basak, Kenneth W. Douglas, Catarina Geraldes, Ozren Jaksic, Zdenek Koristek, Francesco Lanza, Roberto Lemoli, Gabor Mikala, Dominik Selleslag, Nina Worel, Mohamad Mohty, Rafael F. Duarte

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Fludarabine and lenalidomide are essential drugs in the front-line treatment of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), respectively. Data suggests that fludarabine and lenalidomide therapy may have a deleterious effect on stem cell mobilization. In the European compassionate use program, 48 patients (median age 57 years) previously treated with fludarabine (median 5 cycles; range: 1-7 cycles) were given plerixafor plus granulocyte colony-stimulating factor (G-CSF) for remobilization following a primary mobilization attempt. The overall median number of CD34+ cells collected was 2.3 × 106/kg (range: 0.3-13.4). The minimum required number of CD34+ cells (≥2.0 × 106/kg) was collected from 58% of patients in a median of 2 days. Thirty-five patients (median age = 57 years) previously treated with lenalidomide (median 5 cycles; range: 1-10 cycles) were given plerixafor plus G-CSF for remobilization. The overall median number of CD34+ cells collected was 3.4 × 106/kg (range: 1.1-14.8). The minimum required number of CD34+ cells (≥2.0 × 106 per kg) was collected from 69% of patients in a median of 2 days. In conclusion, salvage mobilization with plerixafor plus G-CSF is successful in the majority of patients with MM previously treated with lenalidomide. In fludarabine-exposed patients, only 58% of patients will achieve successful salvage mobilization with plerixafor plus G-CSF, suggesting the need for novel mobilization regimens algorithms in this subgroup of patients.

Original languageEnglish
Pages (from-to)314-317
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number2
DOIs
Publication statusPublished - Feb 1 2012

Keywords

  • Autologous stem cell mobilization
  • Fludarabine
  • Plerixafor
  • Salvage mobilization

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Malard, F., Kröger, N., Gabriel, I. H., Hübel, K., Apperley, J. F., Basak, G. W., Douglas, K. W., Geraldes, C., Jaksic, O., Koristek, Z., Lanza, F., Lemoli, R., Mikala, G., Selleslag, D., Worel, N., Mohty, M., & Duarte, R. F. (2012). Plerixafor for Autologous Peripheral Blood Stem Cell Mobilization in Patients Previously Treated with Fludarabine or Lenalidomide. Biology of Blood and Marrow Transplantation, 18(2), 314-317. https://doi.org/10.1016/j.bbmt.2011.10.003