Plerixafor Can Predictably Mobilize Hematopoietic Stem Cells in Patients With Multiple Myeloma Previously Treated With Lenalidomide

S.R. Tarantolo, P.A. McSweeney, I.N.M. Micallef, L.M. Klein, G. Calandra, D. Huebner
2009 Biology of Blood and Marrow Transplantation  
20.3 months (range: 2.9 -81.2). Relapse was treated with single agent ATO in 22 (59.5%), with ATO1ATRA in 5(13.5%) and with ATO1ATRA1anthracycline in 10 (27%). Thirty five (94.5%) achieved CR (two early deaths). After remission induction, a consolidation course of the same agents used in induction was administered (ATO and ATRA were administered for 28 days), 34 (92%) achieved molecular remission after this course. All patients who achieved molecular remission were offered an autologous SCT.
more » ... autologous SCT. Fourteen patients opted to have an autologous SCT and the remaining patients were scheduled to receive monthly cycles of ATO as a single agent (n 5 14) or ATO1ATRA (n 5 7) for 6 months. The age, sex, duration of first CR, induction and consolidation regimen used to treat relapse was comparable between the patients that underwent an autologous SCT and the remaining patients. Patients who underwent an autologous SCT were conditioned with a conventional Bu/Cy regimen and received PBSC graft with a median cell dose of 5.3 Â 10 6 CD34/Kg (range: 3.54 -9.24). There were no treatment related deaths following the autologous SCT, one patient had an isolated CNS relapse 6 months post transplant. There were no other relapses or deaths in this group. Among the remaining patients who achieved CR but did not have an autologous SCT (n 5 21), 16 relapsed and all except one of these patients eventually died of progressive disease at median period of 1.6 months from second relapse (range: 0 -42.6). At a median follow up of 24 months, the 3-year Kaplan-Meier estimate of EFS among those who received an autologous SCT vs. those that did not was 92.866.8 vs. 28.769.7 (log rank: P 5 0.003). Following remission induction with ATO based regimens in patients with relapsed APL, consolidation with an autologous SCT is associated with a significantly superior clinical outcome in comparison to alternative ATO / ATRA based maintenance regimens.
doi:10.1016/j.bbmt.2008.12.113 fatcat:xs4wtiix2rdfped2pqolvnc5au