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Effect of lenalidomide therapy on mobilization of peripheral blood stem cells in previously untreated multiple myeloma patients

Leukemia volume 22, pages 1280–1281 (2008)Cite this article

Autologous peripheral blood stem cell transplant continues to be one of the standard treatment options for patients with myeloma younger than 70 years of age following induction therapy. Risk factors for impaired stem cell collection include previous exposure to alkylating agents (that is, melphalan), radiation and extensive bone marrow plasma cell infiltration.1 The mobilization strategy employed may also affect stem cell yield.2 Immunomodulatory drugs (for example, thalidomide and lenalidomide) are increasingly being used for induction therapy in patients with multiple myeloma. The impact of these novel agents on stem cell mobilization is worth noting. We have previously reported that induction therapy with a thalidomide-based regimen leads to a lower yield of stem cells when compared to bortezomib.3 Thalidomide use was associated with a reduced yield of stem cells per collection and an increased number of phereses were required to reach pre-determined target goals. Delay in engraftment of platelets by a median of 1 day was also observed.

We read with interest the article by Kumar et al.,4 who reported their experience with mobilizing peripheral blood stem cells (PBSCs) after induction therapy with lenalidomide and dexamethasone. In patients mobilized with granulocyte-colony stimulation factor (G-CSF) alone after treatment with lenalidomide, they observed a significant decrease in total CD34+ cells per kg, average daily yield, day 1 yield and an increased number of phereses were required compared to historical controls treated with dexamethasone alone, thalidomide–dexamethasone or vincristine, adriamycin and dexamethasone chemotherapy. The decrease in PBSC yield correlated with the length of lenalidomide therapy. Regardless, neutrophil and platelet engraftments post-transplant were similar. They recommended PBSC collection be completed within 6 months of initiation of lenalidomide therapy to minimize this decreased yield.

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References

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Authors and Affiliations

  1. Medical Oncology, St Vincent's Medical Center, New York, NY, USA

    A Mazumder, D Vesole & S Jagannath

  2. Winship Cancer Center, Emory University Medical Center, Atlanta, GA, USA

    J Kaufman & S Lonial

  3. Medical Oncology, New York Hospital-Cornell Medical Center, New York, NY, USA

    R Niesvizky

Authors
  1. A Mazumder
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  2. J Kaufman
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  3. R Niesvizky
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  4. S Lonial
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  5. D Vesole
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  6. S Jagannath
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Correspondence to A Mazumder.

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Mazumder, A., Kaufman, J., Niesvizky, R. et al. Effect of lenalidomide therapy on mobilization of peripheral blood stem cells in previously untreated multiple myeloma patients. Leukemia 22, 1280–1281 (2008). https://doi.org/10.1038/sj.leu.2405035

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