Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Stem Cell Procurement

Plerixafor (Mozobil) for stem cell mobilization in patients with multiple myeloma previously treated with lenalidomide

Bone Marrow Transplantation volume 46, pages 350–355 (2011)Cite this article

Subjects

A Corrigendum to this article was published on 12 October 2011

Abstract

Lenalidomide and other new agents have considerable activity in multiple myeloma (MM) and have changed the landscape of treatment. Data suggest that lenalidomide therapy before autologous hematopoietic stem cell transplantation has a detrimental effect on stem cell mobilization. This retrospective study examined the efficacy of plerixafor in combination with G-CSF among patients with MM previously treated with lenalidomide (median, 4 cycles; range, 1–20 cycles). Data were analyzed for 60 patients who received plerixafor plus G-CSF for frontline mobilization in a phase 3 clinical trial or an expanded access program (n=20) or for remobilization in a compassionate use program (n=40). The overall median number of CD34+ cells collected was 5.6 × 106 per kg (range, 0.45 × 106–37.2 × 106). The minimum number of CD34+ cells (⩾2 × 106 per kg) was collected from 86.7% of patients in a median of 1 day. This minimum was collected from 100% of patients who underwent frontline mobilization and 80% of patients who underwent remobilization. These data suggest that CD34+ hematopoietic stem cells can be successfully and predictably collected with combination plerixafor plus G-CSF for primary or secondary mobilization in the majority of patients with MM who have been previously treated with lenalidomide.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med 1996; 335: 91–97.

    Article  CAS  PubMed  Google Scholar 

  2. Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. N Engl J Med 2003; 348: 1875–1883.

    Article  CAS  PubMed  Google Scholar 

  3. Rajkumar SV, Blood E, Vesole D, Fonseca R, Greipp PR . Phase III clinical trial of thalidomide plus dexamethasone compared with dexamethasone alone in newly diagnosed multiple myeloma: a clinical trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol 2006; 24: 431–436.

    Article  CAS  PubMed  Google Scholar 

  4. Harousseau JL, Mathiot C, Attal M, Marit G, Caillot D, Mohty M et al. VELCADE/dexamethasone (Vel/D) versus VAD as induction treatment prior to autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma (MM): updated results of the IFM 2005/01 trial. Blood (ASH Annual Meeting Abstracts) 2007; 110 abstract 450.

  5. Dimopoulos M, Spencer A, Attal M, Prince HM, Harousseau JL, Dmoszynska A et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med 2007; 357: 2123–2132.

    Article  CAS  PubMed  Google Scholar 

  6. Weber DM, Chen C, Niesvizky R, Wang M, Belch A, Stadtmauer EA et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med 2007; 357: 2133–2142.

    Article  CAS  PubMed  Google Scholar 

  7. Rajkumar SV, Hayman SR, Lacy MQ, Dispenzieri A, Geyer SM, Kabat B et al. Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma. Blood 2005; 106: 4050–4053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Lacy MQ, Gertz MA, Dispenzieri A, Hayman SR, Geyer S, Kabat B et al. Long-term results of response to therapy, time to progression, and survival with lenalidomide plus dexamethasone in newly diagnosed myeloma. Mayo Clin Proc 2007; 82: 1179–1184.

    Article  CAS  PubMed  Google Scholar 

  9. Zonder JA, Crowley J, Hussein MA, Bolejack V, Moore DF, Whittenberger BF et al. Superiority of lenalidomide (len) plus high-dose dexamethasone (HD) compared to HD alone as treatment of newly-diagnosed multiple myeloma (NDMM): results of the randomized, double-blinded, placebo-controlled SWOG trial S0232. Blood (ASH Annual Meeting Abstracts) 2007; 110 abstract 77.

  10. Rajkumar SV, Jacobus S, Callander N, Fonseca R, Vesole D, Williams M et al. A randomized trial of lenalidomide plus high-dose dexamethasone (RD) versus lenalidomide plus low-dose dexamethasone (Rd) in newly diagnosed multiple myeloma (E4A03): a trial coordinated by the Eastern Cooperative Oncology Group. Blood (ASH Annual Meeting Abstracts) 2007; 110 abstract 74.

  11. Giralt S, Stadtmauer EA, Harousseau JL, Palumbo A, Bensinger W, Comenzo RL et al. International Myeloma Working Group (IMWG) consensus statement and guidelines regarding the current status of stem cell collection and high-dose therapy for multiple myeloma and the role of plerixafor (AMD 3100). Leukemia 2009; 23: 1904–1912.

    Article  CAS  PubMed  Google Scholar 

  12. Kumar S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Gastineau DA et al. Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma. Leukemia 2007; 21: 2035–2042.

    Article  CAS  PubMed  Google Scholar 

  13. Kumar S, Lacy M, Dispenzieri A, Hayman S, Buadi F, Dingli D et al. Stem cell mobilization following initial therapy with lenalidomide and dexamethasone in patients with newly diagnosed multiple myeloma. Blood (ASH Annual Meeting Abstracts) 2008; 112 abstract 3467.

  14. Mark T, Stern J, Furst JR, Jayabalan D, Zafar F, LaRow A et al. Stem cell mobilization with cyclophosphamide overcomes the suppressive effect of lenalidomide therapy on stem cell collection in multiple myeloma. Biol Blood Marrow Transplant 2008; 14: 795–798.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Mazumder A, Kaufman J, Niesvizky R, Lonial S, Vesole D, Jagannath S . Effect of lenalidomide therapy on mobilization of peripheral blood stem cells in previously untreated multiple myeloma patients. Leukemia 2008; 22: 1280–1281 ; author reply 1281–1282.

    Article  CAS  PubMed  Google Scholar 

  16. Paripati H, Stewart AK, Cabou S, Dueck A, Zepeda VJ, Pirooz N et al. Compromised stem cell mobilization following induction therapy with lenalidomide in myeloma. Leukemia 2008; 22: 1282–1284.

    Article  CAS  PubMed  Google Scholar 

  17. Popat U, Saliba R, Thandi R, Hosing C, Qazilbash M, Anderlini P et al. Impairment of filgrastim-induced stem cell mobilization after prior lenalidomide in patients with multiple myeloma. Biol Blood Marrow Transplant 2009; 15: 718–723.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Genzyme Corporation. Mozobil [package insert] 2008. Cambridge, MA: Genzyme Corporation.

  19. Flomenberg N, Devine SM, DiPersio JF, Liesveld JL, McCarty JM, Rowley SD et al. The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone. Blood 2005; 106: 1867–1874.

    Article  CAS  PubMed  Google Scholar 

  20. DiPersio JF, Stadtmauer EA, Nademanee A, Micallef IN, Stiff PJ, Kaufman JL et al. Plerixafor and G-CSF versus placebo and G-CSF to mobilize hematopoietic stem cells for autologous stem cell transplantation in patients with multiple myeloma. Blood 2009; 113: 5720–5726.

    CAS  PubMed  Google Scholar 

  21. Calandra G, McCarty J, McGuirk J, Tricot G, Crocker SA, Badel K et al. AMD3100 plus G-CSF can successfully mobilize CD34+ cells from non-Hodgkin's lymphoma, Hodgkin's disease and multiple myeloma patients previously failing mobilization with chemotherapy and/or cytokine treatment: compassionate use data. Bone Marrow Transplant 2008; 41: 331–338.

    Article  CAS  PubMed  Google Scholar 

  22. Fowler CJ, Dunn A, Hayes-Lattin B, Hansen K, Hansen L, Lanier K et al. Rescue from failed growth factor and/or chemotherapy HSC mobilization with G-CSF and plerixafor (AMD3100): an institutional experience. Bone Marrow Transplant 2009; 43: 909–917.

    Article  CAS  PubMed  Google Scholar 

  23. Tricot G, Cottler-Fox M, Calandra G . Safety and efficacy assessment of plerixafor in patients with multiple myeloma proven or predicted to be poor mobilizers, including assessment of tumor cell mobilization. Bone Marrow Transplant 2010; 45: 63–68.

    Article  CAS  PubMed  Google Scholar 

  24. Alegre A, Tomás JF, Martínez-Chamorro C, Gil-Fernández JJ, Fernández-Villalta MJ, Arranz R et al. Comparison of peripheral blood progenitor cell mobilization in patients with multiple myeloma: high-dose cyclophosphamide plus GM-CSF vs G-CSF alone. Bone Marrow Transplant 1997; 20: 211–217.

    Article  CAS  PubMed  Google Scholar 

  25. Desikan KR, Barlogie B, Jagannath S, Vesole DH, Siegel D, Fassas A et al. Comparable engraftment kinetics following peripheral-blood stem-cell infusion mobilized with granulocyte colony-stimulating factor with or without cyclophosphamide in multiple myeloma. J Clin Oncol 1998; 16: 1547–1553.

    Article  CAS  PubMed  Google Scholar 

  26. Koç ON, Gerson SL, Cooper BW, Laughlin M, Meyerson H, Kutteh L et al. Randomized cross-over trial of progenitor-cell mobilization: high-dose cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) versus granulocyte-macrophage colony-stimulating factor plus G-CSF. J Clin Oncol 2000; 18: 1824–1830.

    Article  PubMed  Google Scholar 

  27. Kumar S, Giralt S, Stadtmauer EA, Harousseau JL, Palumbo A, Bensinger W et al. Mobilization in myeloma revisited: IMWG consensus perspectives on stem cell collection following initial therapy with thalidomide, lenalidomide or bortezomib-containing regimens. Blood 2009; 114: 1729–1735.

    Article  CAS  PubMed  Google Scholar 

  28. Gertz MA, Kumar SK, Lacy MQ, Dispenzieri A, Hayman SR, Buadi FK et al. Comparison of high-dose CY and growth factor with growth factor alone for mobilization of stem cells for transplantation in patients with multiple myeloma. Bone Marrow Transplant 2009; 43: 619–625.

    Article  CAS  PubMed  Google Scholar 

  29. Dingli D, Nowakowski GS, Dispenzieri A, Lacy MQ, Hayman S, Litzow MR et al. Cyclophosphamide mobilization does not improve outcome in patients receiving stem cell transplantation for multiple myeloma. Clin Lymphoma Myeloma 2006; 6: 384–388.

    Article  CAS  PubMed  Google Scholar 

  30. Fruehauf S, Ehninger G, Hübel K, Topaly J, Goldschmidt H, Ho AD et al. Mobilization of peripheral blood stem cells for autologous transplant in non-Hodgkin's lymphoma and multiple myeloma patients by plerixafor and G-CSF and detection of tumor cell mobilization by PCR in multiple myeloma patients. Bone Marrow Transplant 2010; 45: 269–275.

    Article  CAS  PubMed  Google Scholar 

  31. Stiff P, Micallef I, McCarthy P, Magalhaes-Silverman M, Weisdorf D, Territo M et al. Treatment with plerixafor in non-Hodgkin's lymphoma and multiple myeloma patients to increase the number of peripheral blood stem cells when given a mobilizing regimen of G-CSF: implications for the heavily pretreated patient. Biol Blood Marrow Transplant 2009; 15: 249–256.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The development of this article was supported by Genzyme Corporation. We thank Laura Mahachek for editorial support.

Author information

Authors and Affiliations

  1. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    I N M Micallef

  2. Department of Internal Medicine, Division of Hematology/Oncology, University of, Heidelberg, Heidelberg, Germany

    A D Ho

  3. Department of Medicine, Division of Hematology/Oncology, Lutheran General Hospital, Park Ridge, IL, USA

    L M Klein

  4. Genzyme Corporation, Cambridge, MA, USA

    S Marulkar & P J Gandhi

  5. Rocky Mountain Blood and Marrow Transplant Program, Rocky Mountain Cancer Centers, Denver, CO, USA

    P A McSweeney

Authors
  1. I N M Micallef
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A D Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L M Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Marulkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P J Gandhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P A McSweeney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I N M Micallef.

Ethics declarations

Competing interests

Pritesh Gandhi and Sachin Marulkar are employed by Genzyme Corporation, Cambridge, MA, USA. The other authors declare no conflict of interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Micallef, I., Ho, A., Klein, L. et al. Plerixafor (Mozobil) for stem cell mobilization in patients with multiple myeloma previously treated with lenalidomide. Bone Marrow Transplant 46, 350–355 (2011). https://doi.org/10.1038/bmt.2010.118

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2010.118

Keywords

This article is cited by

Search

Advanced search

Quick links