1. FSBI Russian Research Institute of Hematology and Transfusiology of the Federal Medical and Biological Agency
2. City Hospital N15, St. Petersburg
The aim of the study was to compare effectiveness of different mobilization regimens of hematopoietic stem cells (HSC) with cyclophosphamide and vinorelbine. Data of 43 patients, who were distributed into 2 groups according to mobilized regimens, were analyzed. Nine patients with multiple myeloma (MM) and 6 with lymphoma were included into the first group and were mobilized with cyclophosphamide. In the second group, consisted of 23 patients with MM and 5 with lymphoma, vinorelbine 35 mg/m2 was used for mobilization. All patients were treated with G-SCF too. Autologous stem cell transplantation (AutoSCT) was performed to 34 patients. Significant difference was disclosed only on day of stem cell harvesting: 11 days with cyclophosphamide versus 8 days with vinorelbine; р=0,000. The difference in the level of CD34+ cells in peripheral blood at the first day of aphaeresis has got the borderline significance: 197 versus 94 accordingly; р=0,047. But we did not find any difference in the total number of CD34+ cells. The number of ineffective harvestings was 26.7% and 10.7% accordingly. The days of engraftments were identical in the groups. The toxicity of vinorelbine was minimal. We conclude that vinorelbine and G-SCF combination is effective regimen of HSC mobilization and it may be recommended for older MM patients.
2. Mendeleeva L.P., Votyakova O.M., Pokrovskaya O.S. i dr. Nacionalnie klinicheskie rekomendacii po diagnostike i lecheniu mnojestvennoi mielomi // Gematologiya i trans?fyziologiya. 2016. - N 1. - Prilojenie N 2. - S. 1-24.
3. Gay F., Oliva S., Petrucci M.T. et al. Chemotherapy plus lenalidomide versus autologous transplantation, followed by lenalidomide plus prednisone versus lenalidomide maintenance, in patients with multiple myeloma: a randomised, multicentre, phase 3 trial // Lancet. Oncol. - 2015. - Vol. 16. - N 16. - R. 1617-29.
4. Palumbo A., Cavallo F., Gay F. et al. Autologous transplantation and maintenance therapy in multiple myeloma // N. Engl. J. Med. - 2014. - Vol. 371. - N 10. - R. 895-905.
5. Brioli A., Perrone G., Patriarca F. et al. Successful mobilization of PBSCs predicts favorable outcomes in multiple myeloma patients treated with novel agents and autologous transplantation // Bone. Marrow. Transplant. - 2015. - Vol. 50. - N 5. - R. 673-8.
6. Bensinger W., DiPersio J.F., McCarty J.M. Improving stem cell mobilization strategies: future directions // Bone. Marrow. Transplant. - 2009. - Vol. 43. - N 3. R. 181-95.
7. Nademanee A.P., DiPersio J.F., Maziarz R.T. et al. Plerixafor plus granulocyte colony-stimulating factor versus placebo plus granulocyte colony-stimulating factor for mobilization of CD34+ hematopoietic stem cells in patients with multiple myeloma and low peripheral blood CD34+ cell count: results of a subset analysis of a randomized trial // Biol. Blood. Marrow. Transplant. - 2012. - Vol. 18. - N 10. - R. 1564-72.
8. Chen Y.B., Batchelor T., Li S. et al. Phase II trial of high-dose rituximab with high-dose cytarabine mobilization therapy and high-dose thiotepa, busulfan, and cyclophosphamide (R-TBC) autologous stem cell transplant in patients with CNS involvement by non-Hodgkin lymphoma // Cancer. - 2015. - Vol. 121. N 2. - R. 226-33.
9. Wood W.A., Whitley J., Moore D. et al. Chemomobilization with etoposide is highly effective in patients with multiple myeloma and overcomes the effects of age and prior therapy // Biol. Blood. Marrow. Transplant. - 2011. - Vol. 17. - N 1. - R. 141-6.
10. Magagnoli M., Sarina B., Balzarotti M. et al. Mobilizing potential of ifosfamide/vinorelbine-based chemotherapy in pretreated malignant lymphoma // Bone. Marrow. Transplant. - 2001. - Vol. 28. - N 10. - R. 923-7.
11. Santoro A., Mazza R., Pulsoni A. et al. Bendamustine in combination with gemcitabine and vinorelbine is an effective regimen as induction chemotherapy before autologous stem-cell transplantation for relapsed or refractory Hodgkin lymphoma: final results of a multicenter phase II study // J. Clin. Oncol. - 2016. - V0l. 34. - N 27. - R. 293-9.
12. Annunziata M., Celentano M., Pocali B. et al. Vinorelbine plus intermediate dose cyclophosphamide is an effective and safe regimen for the mobilization of peripheral blood stem cells in patients with multiple myeloma // Ann. Hematol. - 2006. - Vol. 85. - N 6. - R. 394-9.
13. Bargetzi M.J., Passweg J., Baertschi E. et al. Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective // Bone. Marrow. Transplant. - 2003. - Vol. 31. - N 2. - R. 99-103.
14. Heizmann M., O?Meara A.C., Moosmann P.R. et al. Efficient mobilization of PBSC with vinorelbine/G-CSF in patients with malignant lymphoma // Bone. Marrow. Transplant. - 2009. - Vol. 44. - N 2. - R. 75-9.
15. Samaras P., Pfrommer S., Seifert B. et al. Efficacy of vinorelbine plus granulocyte colony-stimulation factor for CD34+ hematopoietic progenitor cell mobilization in patients with multiple myeloma // Biol. Blood. Marrow. Transplant. - 2015. - Vol. 21. - N 1. - R. - 74-80.
16. Kumar S., Dispenzieri A., Lacy M.Q. et al. Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma // Leukemia. - 2007. - Vol. 21. - N 9. - R. 2035-42.
17. Mazumder A., Kaufman J., Niesvizky R. et al. Effect of lenalidomide therapy on mobilization of peripheral blood stem cells in previously untreated multiple myeloma patients // Leukemia. - 2008. - Vol. 22. - N 6. - R. 1280-1.
18. Bhutani D., Zonder J., Valent J. et al. Evaluating the effects of lenalidomide induction therapy on peripheral stem cells collection in patients undergoing autologous stem cell transplant for multiple myeloma // Support. Care. Cancer. - 2013. - Vol. 21. - N 9. - R. 2437-42.
19. De Mel S., Chen Y., Lin A. et al. Vinorelbine-cyclophosphamide compared to cyclophosphamide in peripheral blood stem cell mobilization for multiple myeloma // Blood. - 2015. - Vol. 126. - N 23. - R. 3103.
20. Schmid A., Friess D., Taleghani B.M. et al. Role of plerixafor in autologous stem cell mobilization with vinorelbine chemotherapy and granulocyte-colony stimulating factor in patients with myeloma: a phase II study (PAV-trial) // Leuk. Lymphoma. - 2015. - Vol. 56. - N 3. - R. 608-14.
21. To L.B., Levesque J.P., Herbert K.E. How I treat patients who mobilize hematopoietic stem cells poorly // Blood. - 2011. - Vol. 118. - N 17. - R. 4530-40.
22. Pozotrigo M., Adel N., Landau H. et al. Factors impacting stem cell mobilization failure rate and efficiency in multiple myeloma in the era of novel therapies: experience at Memorial Sloan Kettering Cancer Center // Bone. Marrow. Transplant. - 2013. - Vol. 48. - N 8. - R. 1033-9.
23. Mark T., Stern J., Furst J.R. et al. Stem cell mobilization with cyclophosphamide overcomes the suppressive effect of lenalidomide therapy on stem cell collection in multiple myeloma // Biol. Blood. Marrow. Transplant. - 2008. - Vol. 14. - N 7. - R. 795-8.