Phase 2 trial of intravenously administered plerixafor for stem cell mobilization in patients with multiple myeloma following lenalidomide-based initial therapy

Shaji K Kumar, Joseph R Mikhael, B. Laplant, Martha Lacy, F. K. Buadi, David M Dingli, Morie Gertz, K. Laumann, T. Miceli, M. Mahlman, Peter Leif Bergsagel, S. R. Hayman, C. Reeder, Alexander Keith Stewart, Angela Dispenzieri, D. A. Gastineau, J. L. Winters

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Initial therapy of multiple myeloma with lenalidomide-based regimens can compromise stem cell collection, which can be overcome with the addition of plerixafor. Plerixafor is typically given subcutaneously (SQ), with collection ∼11 h later for maximum yield. Intravenous administration may allow more rapid and predictable mobilization. This trial was designed to assess the efficacy and feasibility of IV plerixafor in patients receiving initial therapy with a lenalidomide-based regimen. Patients received G-CSF at 10 μg/kg/day for 4 days followed by IV plerixafor at 0.24 mg/kg/dose starting on day 5; plerixafor was administered early in the morning with apheresis 4-5 h later. Thirty-eight (97%) patients collected at least 3 × 106 CD34+ cells/kg within 2 days of apheresis. The median CD34+ cells/kg after 1 day of collection was 3.9 × 106 (range: 0.7-9.2) and after 2 days of collection was 6.99 × 106 (range: 1.1-16.5). There were no grade 3 or 4 non-hematological adverse events, and one patient experienced grade 4 thrombocytopenia. The most common adverse events were nausea, diarrhea and abdominal bloating. IV plerixafor is an effective strategy for mobilization with low failure rate and is well tolerated. It offers flexibility with a schedule of early-morning infusion followed by apheresis later in the day.

Original languageEnglish (US)
Pages (from-to)201-205
Number of pages5
JournalBone Marrow Transplantation
Volume49
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Hematopoietic Stem Cell Mobilization
Multiple Myeloma
Blood Component Removal
Therapeutics
Granulocyte Colony-Stimulating Factor
Intravenous Administration
Nausea
JM 3100
lenalidomide
Diarrhea
Appointments and Schedules
Stem Cells

Keywords

  • Apheresis
  • Multiple myeloma
  • Plerixafor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Phase 2 trial of intravenously administered plerixafor for stem cell mobilization in patients with multiple myeloma following lenalidomide-based initial therapy. / Kumar, Shaji K; Mikhael, Joseph R; Laplant, B.; Lacy, Martha; Buadi, F. K.; Dingli, David M; Gertz, Morie; Laumann, K.; Miceli, T.; Mahlman, M.; Bergsagel, Peter Leif; Hayman, S. R.; Reeder, C.; Stewart, Alexander Keith; Dispenzieri, Angela; Gastineau, D. A.; Winters, J. L.

In: Bone Marrow Transplantation, Vol. 49, No. 2, 02.2014, p. 201-205.

Research output: Contribution to journalArticle

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abstract = "Initial therapy of multiple myeloma with lenalidomide-based regimens can compromise stem cell collection, which can be overcome with the addition of plerixafor. Plerixafor is typically given subcutaneously (SQ), with collection ∼11 h later for maximum yield. Intravenous administration may allow more rapid and predictable mobilization. This trial was designed to assess the efficacy and feasibility of IV plerixafor in patients receiving initial therapy with a lenalidomide-based regimen. Patients received G-CSF at 10 μg/kg/day for 4 days followed by IV plerixafor at 0.24 mg/kg/dose starting on day 5; plerixafor was administered early in the morning with apheresis 4-5 h later. Thirty-eight (97{\%}) patients collected at least 3 × 106 CD34+ cells/kg within 2 days of apheresis. The median CD34+ cells/kg after 1 day of collection was 3.9 × 106 (range: 0.7-9.2) and after 2 days of collection was 6.99 × 106 (range: 1.1-16.5). There were no grade 3 or 4 non-hematological adverse events, and one patient experienced grade 4 thrombocytopenia. The most common adverse events were nausea, diarrhea and abdominal bloating. IV plerixafor is an effective strategy for mobilization with low failure rate and is well tolerated. It offers flexibility with a schedule of early-morning infusion followed by apheresis later in the day.",
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AU - Lacy, Martha

AU - Buadi, F. K.

AU - Dingli, David M

AU - Gertz, Morie

AU - Laumann, K.

AU - Miceli, T.

AU - Mahlman, M.

AU - Bergsagel, Peter Leif

AU - Hayman, S. R.

AU - Reeder, C.

AU - Stewart, Alexander Keith

AU - Dispenzieri, Angela

AU - Gastineau, D. A.

AU - Winters, J. L.

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