KRD-PACE Mobilization for Multiple Myeloma Patients With Significant Residual Disease Before Autologous Stem-Cell Transplantation
Published by Elsevier Inc..
BACKGROUND: Bortezomib has been incorporated into thalidomide and dexamethasone provided with cisplatin, doxorubicin, cyclophosphamide, and etoposide (PACE) as an intensive regimen before autologous stem-cell transplantation for multiple myeloma (MM). We examined MM patients at our center who received chemomobilization with a regimen that substituted carfilzomib and lenalidomide for bortezomib and thalidomide (KRD-PACE).
PATIENTS AND METHODS: This was a retrospective study of 27 MM patients who received KRD-PACE for chemomobilization. Our analysis included patients who had circulating plasma cells (CPCs) by flow cytometry, ≥ 10% bone marrow plasma cells (BMPC), a monoclonal protein ≥ 1 g/dL, or an involved serum free light chain ≥ 10 mg/dL.
RESULTS: The most common indication for KRD-PACE was BMPC ≥ 10% in 16 patients (60%), followed by CPCs in 11 (41%). The median (range) age was 61 (35-69) years, and the median (range) BMPC before treatment was 10% (5%-47%). The overall response rate was 43%, and a median (range) of 20.24 (8.08-69.88) × 106 CD34+ cells/kg were collected. CPC clearance rate was 50%, and the median reduction in BMPC was 75%. Two patients had sinus bradycardia and 5 (19%) had neutropenic fever.
CONCLUSION: KRD-PACE is an effective therapy to mobilize peripheral blood stem cells in MM patients with residual disease burden. This regimen was successful at clearing CPCs and reducing BMPC burden, with an overall response rate of 43%. Despite theoretical concern regarding the combination of 3 cardiotoxic agents, we observed a low frequency of cardiac issues.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Clinical lymphoma, myeloma & leukemia - 20(2020), 9 vom: 13. Sept., Seite 602-609 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cowan, Andrew J [VerfasserIn] |
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| Links: |
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| Themen: |
Autologous stem cell transplantation |
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| Anmerkungen: |
Date Completed 07.09.2021 Date Revised 07.09.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clml.2020.04.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM310390443 |
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| 520 | |a Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: Bortezomib has been incorporated into thalidomide and dexamethasone provided with cisplatin, doxorubicin, cyclophosphamide, and etoposide (PACE) as an intensive regimen before autologous stem-cell transplantation for multiple myeloma (MM). We examined MM patients at our center who received chemomobilization with a regimen that substituted carfilzomib and lenalidomide for bortezomib and thalidomide (KRD-PACE) | ||
| 520 | |a PATIENTS AND METHODS: This was a retrospective study of 27 MM patients who received KRD-PACE for chemomobilization. Our analysis included patients who had circulating plasma cells (CPCs) by flow cytometry, ≥ 10% bone marrow plasma cells (BMPC), a monoclonal protein ≥ 1 g/dL, or an involved serum free light chain ≥ 10 mg/dL | ||
| 520 | |a RESULTS: The most common indication for KRD-PACE was BMPC ≥ 10% in 16 patients (60%), followed by CPCs in 11 (41%). The median (range) age was 61 (35-69) years, and the median (range) BMPC before treatment was 10% (5%-47%). The overall response rate was 43%, and a median (range) of 20.24 (8.08-69.88) × 106 CD34+ cells/kg were collected. CPC clearance rate was 50%, and the median reduction in BMPC was 75%. Two patients had sinus bradycardia and 5 (19%) had neutropenic fever | ||
| 520 | |a CONCLUSION: KRD-PACE is an effective therapy to mobilize peripheral blood stem cells in MM patients with residual disease burden. This regimen was successful at clearing CPCs and reducing BMPC burden, with an overall response rate of 43%. Despite theoretical concern regarding the combination of 3 cardiotoxic agents, we observed a low frequency of cardiac issues | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autologous stem cell transplantation | |
| 650 | 4 | |a Chemomobilization | |
| 650 | 4 | |a Circulating plasma cells | |
| 650 | 4 | |a Refractory myeloma | |
| 650 | 4 | |a Stem-cell mobilization and collection | |
| 700 | 1 | |a Green, Damian J |e verfasserin |4 aut | |
| 700 | 1 | |a Karami, Mehdi |e verfasserin |4 aut | |
| 700 | 1 | |a Becker, Pamela S |e verfasserin |4 aut | |
| 700 | 1 | |a Tuazon, Sherilyn |e verfasserin |4 aut | |
| 700 | 1 | |a Coffey, David G |e verfasserin |4 aut | |
| 700 | 1 | |a Hyun, Teresa S |e verfasserin |4 aut | |
| 700 | 1 | |a Libby, Edward N |e verfasserin |4 aut | |
| 700 | 1 | |a Gopal, Ajay K |e verfasserin |4 aut | |
| 700 | 1 | |a Holmberg, Leona A |e verfasserin |4 aut | |
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