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

Overview

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.

authors

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

publication date

  • June 26, 2009

Research

keywords

  • Boronic Acids
  • Hematopoietic Stem Cell Mobilization
  • Hematopoietic Stem Cell Transplantation
  • Medical Oncology
  • Multiple Myeloma
  • Pyrazines
  • Thalidomide

Identity

Scopus Document Identifier

  • 70349260793

Digital Object Identifier (DOI)

  • 10.1182/blood-2009-04-205013

PubMed ID

  • 19561323

Additional Document Info

volume

  • 114

issue

  • 9