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Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience

Bone Marrow Transplantation volume 56, pages 395–399 (2021)Cite this article

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Abstract

Triplet-drug regimen bortezomib–thalidomide–dexamethasone (VTD) and bortezomib–lenalidomide–dexamethasone (VRD) are considered as standard of care induction prior autologous stem-cell transplantation (ASCT) in myeloma. In addition to improve response rate, induction therapy should preserve an adequate stem-cell collection. In the present retrospective study, we analyzed stem-cell collection in 325 newly diagnosed myeloma patients who received either VTD or VRD induction before ASCT. Stem-cell mobilization consisted of intravenous cyclophosphamide plus G-CSF. Plerixafor was administered preemptively to rescue mobilization. In comparison with VTD, VRD induction was associated with a more frequent use of plerixafor (19.3% versus 5.4%, p = 0.004) and with an increased number of apheresis to reach adequate collection (>2 apheresis required in 42.3% versus 30.2%, p = 0.05). Moreover, more patients experienced collection failure in the VRD group (6% versus 1.8%, p = 0.004). The median number of CD34-positive cells (×106/kg) was lower in the VRD group: 8.5 versus 9.3 (p = 0.05) in the VTD group. The vast majority of patients underwent ASCT (93% versus 98%, in VRD and VTD group, respectively). These data highlight the need of optimal stem-cell collection strategy, especially in the context of tandem transplantation and incorporation of anti-CD38 monoclonal antibody into induction.

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Fig. 1: Impact of VTD or VRD induction on stem-cell collection.

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Acknowledgements

CT, PM, and SLG, are members of Site de Recherche Intégrée sur le Cancer (SIRIC) ILIAD, (INCA-DGOS-Inserm_12558).

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Authors and Affiliations

  1. Pharmacie Clinique Oncologique, Hotel Dieu, Nantes, France

    Vanille Laurent, Clémentine Fronteau & Nicolas Cormier

  2. Service d’Hématologie Clinique, Hotel Dieu, Nantes, France

    Chloé Antier, Benoit Tessoulin, Thomas Gastinne, Béatrice Mahé, Nicolas Blin, Viviane Dubruille, Anne Lok, Patrice Chevallier, Thierry Guillaume, Alice Garnier, Pierre Peterlin, Amandine Le Bourgeois, Sophie Vantyghem, Steven Le Gouill, Philippe Moreau & Cyrille Touzeau

  3. Etablissement Français du Sang, Nantes, France

    Pascale Dupuis

  4. Université de Nantes, Faculté de Médecine, Nantes, France

    Benoit Tessoulin, Patrice Chevallier, Sophie Vantyghem, Steven Le Gouill, Philippe Moreau & Cyrille Touzeau

  5. Service d’Hématologie Clinique, Centre Hospitalier Departemental, La Roche sur Yon, France

    Mourad Tiab

  6. Service d’Hématologie Clinique, Centre Hospitalier, Vannes, France

    Pascal Godmer

  7. Hôpital Privé Le Confluent, Nantes, France

    Sophie Sadot

  8. Service d’Hématologie Clinique, Centre Hospitalier, Saint Nazaire, France

    Marion Loirat

  9. Service d’Hématologie Clinique, Centre Hospitalier, Lorient, France

    Adrien Trebouet

  10. CRCINA, INSERM, CNRS, Université de Nantes, Nantes, France

    Steven Le Gouill, Philippe Moreau & Cyrille Touzeau

  11. Site de Recherche Intégrée sur le Cancer (SIRIC), ILIAD, Nantes, France

    Steven Le Gouill, Philippe Moreau & Cyrille Touzeau

  12. Université de Nantes, Nantes, France

    Steven Le Gouill, Philippe Moreau & Cyrille Touzeau

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  1. Vanille Laurent
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Contributions

VL, CF, and CT, designed the study. VL, CF, CA, and CT, collected data. BT, performed statistical analysis. PD, performed stem-cell harvesting. CT, and VL, wrote the manuscript. All authors treated patients and critically reviewed the manuscript, and gave final approval.

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Correspondence to Cyrille Touzeau.

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CT and PM are advisory board member and received honoraria from Sanofi.

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Laurent, V., Fronteau, C., Antier, C. et al. Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience. Bone Marrow Transplant 56, 395–399 (2021). https://doi.org/10.1038/s41409-020-01033-8

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