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

S. K. Kumar, J. Mikhael, B. Laplant, M. Q. Lacy, F. K. Buadi, D. Dingli, M. A. Gertz, K. Laumann, T. Miceli, M. Mahlman, L. P. Bergsagel, S. R. Hayman, C. Reeder, A. K. Stewart, A. Dispenzieri, D. A. Gastineau, J. L. Winters

Research output: Contribution to journalArticle

16 Scopus citations

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

Keywords

  • Apheresis
  • Multiple myeloma
  • Plerixafor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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