Journal
BONE MARROW TRANSPLANTATION
Volume 49, Issue 2, Pages 201-205Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bmt.2013.175
Keywords
plerixafor; multiple myeloma; apheresis
Categories
Funding
- Mayo Clinic Hematological Malignancies Program
- Paul Calabresi K12 Award [CA96028]
- Mayo Clinic Cancer Center and the Mayo Foundation
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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 similar to 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 mg/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 x 10(6) CD34+ cells/kg within 2 days of apheresis. The median CD34+ cells/kg after 1 day of collection was 3.9 x 10(6) (range: 0.7-9.2) and after 2 days of collection was 6.99 x 10(6) (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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