Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma

S. Kumar, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, F. K. Buadi, D. A. Gastineau, M. R. Litzow, R. Fonseca, V. Roy, S. V. Rajkumar, M. A. Gertz

Research output: Contribution to journalArticlepeer-review

253 Scopus citations

Abstract

While initial therapies have become highly effective with introduction of lenalidomide and bortezomib and patients may opt for delayed stem cell transplantation, it is important to collect stem cells for future transplant. Given its increasing use as initial therapy, we examined if lenalidomide had any impact on the ability to collect peripheral blood stem cells (PBSC). We studied the entire cohort of patients with myeloma undergoing PBSC mobilization at our institution during a 5-year period, comparing the results between patients receiving different initial therapies. Among those mobilized with granulocyte-colony stimulating factor (G-CSF) alone, there was a significant decrease in total CD34+ cells collected (P<0.001), average daily collection (P<0.001), day 1 collection (P<0.001) and increased number of aphereses (P<0.004) in patients treated with lenalidomide compared to those receiving dexamethasone, thalidomide-dexamethasone or VAD. A similar trend was seen in those mobilized with chemotherapy and G-CSF. A trend was seen towards decreased PBSC yield with increasing duration of lenalidomide therapy as well as increasing age (P = 0.002). There was no effect on quality of PBSC collected based on similar engraftment across all groups. We recommend collection of PBSC within 6 months of initiation of therapy with lenalidomide containing regimens to minimize the risk of mobilization failures.

Original languageEnglish (US)
Pages (from-to)2035-2042
Number of pages8
JournalLeukemia
Volume21
Issue number9
DOIs
StatePublished - Sep 2007

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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