Mobilization in myeloma revisited: IMWG consensus perspectives on stem cell collection following initial therapy with thalidomide-, lenalidomide-, or bortezomib-containing regimens

Shaji Kumar, Sergio Giralt, Edward A. Stadtmauer, Jean L. Harousseau, Antonio Palumbo, William Bensinger, Raymond L. Comenzo, Suzanne Lentzsch, Nikhil Munshi, Ruben Niesvizky, Jesus San Miguel, Heinz Ludwig, Leif Bergsagel, Joan Blade, Sagar Lonial, Kenneth C. Anderson, Patrizia Tosi, Pieter Sonneveld, Orhan Sezer, David VesoleMichele Cavo, Hermann Einsele, Paul G. Richardson, Brian G.M. Durie, S. Vincent Rajkumar

Research output: Contribution to journalReview articlepeer-review

165 Scopus citations

Abstract

The past decade has witnessed a paradigm shift in the initial treatment of multiple myeloma with the introduction of novel agents such as thalidomide, lenalidomide, and bortezomib, leading to improved outcomes. High-dose therapy and autologous stem cell transplantation remains an important therapeutic option for patients with multiple myeloma eligible for the procedure. Before the advent of the novel agents, patients underwent stem cell collection prior to significant alkylating agent exposure, given its potential deleterious effect on stem cell collection. With increasing use of the novel agents in the upfront setting, several reports have emerged raising concerns about their impact on the ability to collect stem cells.An expert panel of the International Myeloma Working Group (IMWG) was convened to examine the implications of these therapies on stem collection in patients with myeloma and to develop recommendations for addressing these issues. Here we summarize the currently available data and present our perspective on the problem and potential options to overcome this problem. Specifically, we recommend early mobilization of stem cells, preferably within the first 4 cycles of initial therapy, in patients treated with novel agents and encourage participation in clinical trials evaluating novel approaches to stem cell mobilization.

Original languageEnglish (US)
Pages (from-to)1729-1735
Number of pages7
JournalBlood
Volume114
Issue number9
DOIs
StatePublished - 2009

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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