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Myeloma

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

Leukemia volume 21, pages 1294–1299 (2007)Cite this article

Abstract

In a phase III randomized, multicenter study, the German-speaking Myeloma-Multicenter Group (GMMG) and the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON) group investigated the influence of thalidomide (Thal) on the outcome of peripheral blood stem cell (PBSC) collection in multiple myeloma (MM) before peripheral autologous blood stem cell transplantation (ABSCT). We analyzed the data of 398 myeloma patients after induction with Thal, doxorubicin and dexamethasone (TAD) in comparison with vincristine, doxorubicin and dexamethasone (VAD) followed by mobilization with cyclophosphamide, doxorubicin, dexamethasone (CAD) and PBSC collection. Within both the study groups, patients treated with TAD showed to collect significantly fewer CD34+ cells compared with VAD (GMMG, TAD: median 9.8 × 106/kg; range 2.0–33.6; VAD: median 10.9 × 106/kg range 3.0–36.0; P=0.02) (HOVON, TAD: median 7.4 × 106/kg; range 2.0–33.0; VAD: median 9.4 × 106/kg; range 0.0–48.7; P=0.009). However, engraftment after peripheral autologous stem cell transplantation showed no difference between Thal and VAD groups. We conclude that Thal as a part of induction regimen is associated with better response rates (GMMG-HD3: CR/PR 79%, VAD: CR/PR 58%; HOVON-50: TAD: CR/PR 81%, VAD: CR/PR 61%), but significantly affects the yield of PBSC collection. Nevertheless, the number of total CD34+ cells collected was sufficient for double autologous transplantation in 82% of the Thal patients, with at least 2.5 × 106/kg CD34+ cells.

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Acknowledgements

We thank Olga Kien, Marion Schaeffner-Fank and Jana Schlenzka, MD, from the GMMG clinical trial center, Department of Hematology and Oncology at the University of Heidelberg and the National Center of Tumor Diseases Heidelberg, and Christiane Heiß from the Data Center of the National Center of Tumor Diseases Heidelberg, Germany; Petra Westveer and Edwin van Stein from the HOVON Data Center, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands, for data management and Douglas W McMillin from the Dana-Farber Cancer Institute, The Jerome Lipper Multiple Myeloma Center, Harvard Medical School, Boston, USA, for proofreading.

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Author notes

  1. I Breitkreutz: Iris Breitkreutz, MD, performed this work at the University of Heidelberg, Department of Hematology/Oncology, INF 410, 69120 Heidelberg, Germany.

Authors and Affiliations

  1. Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany

    I Breitkreutz, M S Raab, F W Cremer & H Goldschmidt

  2. Department of Hematology, University Medical Center, Utrecht, The Netherlands

    H M Lokhorst

  3. Department of Trials & Statistics-HOVON Data Center, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

    B van der Holt

  4. Cytonet GmbH, Heidelberg, Germany

    D Herrmann

  5. Department of Internal Medicine I, University of Bonn, Bonn, Germany

    A Glasmacher & I G H Schmidt-Wolf

  6. Department of Internal Medicine III, University of Berlin,

    I W Blau

  7. CBF, University of Berlin, Berlin, Germany

    I W Blau

  8. Department of Internal Medicine,

    H Martin

  9. University of Frankfurt, Frankfurt, Germany

    H Martin

  10. Department of Internal Medicine, AKA, Hamburg, Germany

    H Salwender

  11. Department of Internal Medicine III, Clinic Chemnitz GmbH, Chemnitz, Germany

    A Haenel

  12. Department of Hematology, Erasmus University Medical Center Rotterdam, The Netherlands

    P Sonneveld

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Correspondence to I Breitkreutz.

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Breitkreutz, I., Lokhorst, H., Raab, M. et al. Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield. Leukemia 21, 1294–1299 (2007). https://doi.org/10.1038/sj.leu.2404661

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