Impairment of filgrastim-induced stem cell mobilization after prior lenalidomide in patients with multiple myeloma. Academic Article uri icon

Overview

abstract

  • Lenalidomide is an agent that has shown great activity in patients with multiple myeloma (MM). However, studies have suggested that this drug negatively affects subsequent stem cell collection. To investigate whether lenalidomide impairs stem cell mobilization and collection, we reviewed data for patients with MM who underwent mobilization with filgrastim. Predictors of mobilization failure were evaluated using logistic regression analysis. In 26 (9%) of 302 myeloma patients, stem cell mobilization failed. Mobilization failed in 25% of patients who had previously received lenalidomide, compared with 4% of patients who had not received lenalidomide (P < .001). In a multivariate analysis, prior lenalidomide use (odds ratio: 5.9; 95% confidence interval [CI]: 2.4-14.3) and mobilization more than 1 year after diagnosis (odds ratio: 4.6; 95% CI: 1.9-11.1) were significantly associated with failed mobilization. Twenty-one of 26 patients in whom mobilization with filgrastim failed underwent remobilization with chemotherapy and filgrastim; in 18 (86%) of these 21 patients, stem cells were successfully mobilized and collected. In patients with multiple myeloma, prior lenalidomide therapy is associated with failure of stem cell mobilization with filgrastim. Remobilization with chemotherapy and filgrastim is usually successful in these patients.

publication date

  • April 8, 2009

Research

keywords

  • Antineoplastic Agents
  • Bone Marrow
  • Granulocyte Colony-Stimulating Factor
  • Hematopoietic Stem Cell Mobilization
  • Multiple Myeloma
  • Peripheral Blood Stem Cell Transplantation
  • Thalidomide

Identity

PubMed Central ID

  • PMC4352933

Scopus Document Identifier

  • 67349243088

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2009.02.011

PubMed ID

  • 19450756

Additional Document Info

volume

  • 15

issue

  • 6