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Stem Cell Harvesting after Bortezomib-Based Reinduction for Myeloma Relapsing after Autologous Transplantation: Results from the British Society of Blood and Marrow Transplantation/United Kingdom Myeloma Forum Myeloma X (Intensive) Trial.
- Source :
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Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2016 Jun; Vol. 22 (6), pp. 1009-1016. Date of Electronic Publication: 2016 Jan 28. - Publication Year :
- 2016
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Abstract
- The phase III British Society of Blood and Marrow Transplantation/United Kingdom Myeloma Forum Myeloma X trial (MMX) demonstrated prospectively, for the first time, superiority of salvage autologous stem cell transplantation over chemotherapy maintenance for multiple myeloma (MM) in first relapse after previous ASCT. However, many patients have stored insufficient stem cells (PBSC) for second ASCT and robust evidence for remobilization after first ASCT is lacking. We report the feasibility, safety, and efficacy of remobilization after bortezomib-doxorubicin-dexamethasone reinduction in MMX and outcomes of second ASCT with these cells. One hundred ten patients underwent ≥1 remobilization with 32 and 4, undergoing second and third attempts, respectively. Toxicities of remobilization were similar to those seen in first-line mobilization. After all attempts, 52% of those with insufficient previously stored PBSC had harvested a sufficient quantity to proceed to second ASCT. Median PBSC doses infused, neutrophil engraftment, and time to discharge after second ASCT were similar regardless of stem cell source, as were the toxicities of second ASCT. No significant differences between PBSC sources were noted in depth of response to ASCT or time to progression. Harvesting after bortezomib-doxorubicin-dexamethasone reinduction for MM at first relapse is safe and feasible and yields a reliable cell product for second ASCT. The study is registered with ClinicalTrials.gov (NCT00747877) and EudraCT (2006-005890-24).<br /> (Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Dexamethasone therapeutic use
Doxorubicin therapeutic use
Female
Hematopoietic Stem Cell Mobilization standards
Humans
Maintenance Chemotherapy methods
Maintenance Chemotherapy standards
Male
Middle Aged
Remission Induction methods
Transplantation, Autologous
Treatment Outcome
United Kingdom
Bortezomib therapeutic use
Hematopoietic Stem Cell Mobilization methods
Hematopoietic Stem Cell Transplantation methods
Leukapheresis standards
Multiple Myeloma therapy
Salvage Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 22
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 26827659
- Full Text :
- https://doi.org/10.1016/j.bbmt.2016.01.016