Yazarlar : Malard F, Kröger N, Gabriel IH, Hübel K, Apperley JF, Basak GW, Douglas KW, Geraldes C, Jaksic O, Koristek Z, Lanza F, Lemoli R, Mikala G, Selleslag D, Worel N, Mohty M, Duarte RF.

Yayın : Biol Blood Marrow Transplant.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22001752

Konu : Kemik İliği Nakli

Literatür İçeriği :  

Abstract

Fludarabine and lenalidomide are essential drugs in the front-line treatment of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), respectively. Data suggests that fludarabine and lenalidomide therapy may have a deleterious effect on stem cell mobilization. In the European compassionate use program, 48 patients (median age 57 years) previously treated with fludarabine (median 5 cycles; range: 1-7 cycles) were given plerixafor plus granulocyte colony-stimulating factor (G-CSF) for remobilization following a primary mobilization attempt. The overall median number of CD34(+) cells collected was 2.3 × 10(6)/kg (range: 0.3-13.4). The minimum required number of CD34(+) cells (≥2.0 × 10(6)/kg) was collected from 58% of patients in a median of 2 days. Thirty-five patients (median age = 57 years) previously treated with lenalidomide (median 5 cycles; range: 1-10 cycles) were given plerixafor plus G-CSF for remobilization. The overall median number of CD34(+) cells collected was 3.4 × 10(6)/kg (range: 1.1-14.8). The minimum required number of CD34(+) cells (≥2.0 × 10(6) per kg) was collected from 69% of patients in a median of 2 days. In conclusion, salvage mobilization with plerixafor plus G-CSF is successful in the majority of patients with MM previously treated with lenalidomide. In fludarabine-exposed patients, only 58% of patients will achieve successful salvage mobilization with plerixafor plus G-CSF, suggesting the need for novel mobilization regimens algorithms in this subgroup of patients.

Literatür Arşivi