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NSAID treatment with meloxicam enhances peripheral stem cell mobilization in myeloma

Bone Marrow Transplantation volume 53, pages 175–179 (2018)Cite this article

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Abstract

Chemotherapy with G–CSF is used to mobilize peripheral stem cells in multiple myeloma (MM) patients, with plerixafor as a rescue strategy for poorly mobilizing patients. Preclinical studies suggested that the nonsteroidal anti-inflammatory drug meloxicam enhances the mobilization of CD34+ cells. In this single-center study, we evaluated whether adding meloxicam to chemotherapy/G–CSF mobilization increases peripheral hematopoietic CD34+ cell levels and reduces the need of using plerixafor. We prospectively compared two consecutive cohorts of MM patients in first remission mobilized with G–CSF and non-myelosuppressive chemotherapy with vinorelbine or gemcitabine. The second cohort additionally received oral meloxicam. The cohorts comprised 84 patients without meloxicam (−M) and 66 patients with meloxicam (+M). Meloxicam was well tolerated and associated with similar hematologic engraftment after transplantation and equal survival rates. However, the meloxicam group had higher CD34+ cell levels on day 8 of the mobilization procedure (53 200 versus 35 600 CD34+ cells/mL; P=0.007), and fewer patients needed >1 collection day (+M: 6 (9%) patients versus −M: 16 (19%) patients; P=0.04). This resulted in reduced plerixafor administrations (+M: 7 (11%) patients versus −M: 18 (21%) patients; P=0.03) and less costs. Our data suggest that meloxicam enhances the mobilization of hematopoietic CD34+ blood cells in MM patients.

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Acknowledgements

We thank the data management, the apheresis, the flow cytometry and the stem cell laboratory teams of the ASCT program at the University Hospital of Bern and its associated partner hospital and collaborators for documentation of data relevant for this study.

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Authors and Affiliations

  1. Department of Medical Oncology, Inselspital, University Hospital and University of Bern, Bern, Switzerland,

    B Jeker, U Novak & T Pabst

  2. Department of Hematology, Inselspital, University Hospital and University of Bern, Bern, Switzerland,

    B Mansouri Taleghani & G M Baerlocher

  3. Department of Clinical Research, University of Bern, Bern, Switzerland,

    K Seipel & B U Mueller

  4. SAKK Coordinating Centre, Bern, Switzerland

    M Bigler

  5. Department of Oncology, Kantonsspital, Fribourg, Switzerland

    D Betticher

  6. Department of Oncology, Regionalspital, Thun, Switzerland

    J-M Luethi

  7. Department of Oncology, Kantonsspital, Solothurn, Switzerland

    S Farese

  8. Department of Hematology, Kantonsspital, Lucerne, Switzerland

    A Ruefer

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  1. B Jeker
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  2. U Novak
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Correspondence to T Pabst.

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Jeker, B., Novak, U., Mansouri Taleghani, B. et al. NSAID treatment with meloxicam enhances peripheral stem cell mobilization in myeloma. Bone Marrow Transplant 53, 175–179 (2018). https://doi.org/10.1038/bmt.2017.234

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