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Reduced steady state-based peripheral blood stem cell harvest rate in multiple myeloma treated with bortezomib-based induction regimens

Leukemia volume 26, pages 2552–2554 (2012)Cite this article

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The combination of high-dose melphalan supported by autologous stem cell transplantation (ASCT) has significantly increased response rate and survival in patients with multiple myeloma (MM), and is now considered the new standard of care for patients eligible to the transplant procedure.1 The peripheral blood stem cells (PBSC) collection is preceded by the induction chemotherapy to decrease the tumor mass within the bone marrow, also participating on in vivo purging to decrease the contamination of the stem cell collection with tumor cells. Mobilization and cytapheresis generally takes place following cycle 3 or 4 of induction, and steady state remains considered the easiest and safest way to collect PBSC.2

The VAD (vincristin-adriamycin-dexamethasone) was the historical induction regimen, before the era of targeted novel agents;3 however, the bortezomib-based induction therapy has become the gold standard, with increased response rates and prolonged progression-free survival.1 The previous studies showed that bortezomib had no toxic effects on stem cells, megakaryocytes or neutrophil precursors, nor on the quality of PBSC as defined by engraftment time, and causes only transient and reversible thrombocytopenia and neutropenia.4 Nonetheless, we have noticed in-house that the amount of days of collection may increase following bortezomib-dexamethasone (VD) induction as compared with VAD, although the final harvested PBSC amount appeared identical. We have therefore hypothesized that bortezomib-based induction therapy decreased the quality of harvest during the mobilization process, and that might correlate to an increased days of collection and consequently impacted significantly on the cost of the procedure.

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Author notes

  1. S Manier and M Barthelemy: These authors are co first author, and participated equally to this study.

Authors and Affiliations

  1. Service des Maladies du Sang, Hôpital Huriez, CHRU, Lille, France

    S Manier, M Barthelemy, G Fouquet, C Prod’homme, E Le Ray, M P Noel, L Terriou, T Facon & X Leleu

  2. Laboratoire d’Hématologie, Culture Cellulaire, CHRU, Lille, France

    M Barthelemy & C Cossment

  3. Thérapie Cellulaire, Service des aphérèses, EFS Nord de, Lille, France

    P Samarcq & F Boulanger

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  1. S Manier
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Correspondence to X Leleu.

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Manier, S., Barthelemy, M., Fouquet, G. et al. Reduced steady state-based peripheral blood stem cell harvest rate in multiple myeloma treated with bortezomib-based induction regimens. Leukemia 26, 2552–2554 (2012). https://doi.org/10.1038/leu.2012.138

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