Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience
Vanille Laurent
(1)
,
Clémentine Fronteau
(1)
,
Chloé Antier
(1)
,
Pascale Dupuis
(2)
,
Benoit Tessoulin
(1, 3)
,
Thomas Gastinne
(1)
,
Béatrice Mahé
(1)
,
Nicolas Blin
(1)
,
Viviane Dubruille
(1)
,
Anne Lok
(1)
,
Patrice Chevallier
(1, 3)
,
Thierry Guillaume
(1)
,
Alice Garnier
(1)
,
Pierre Peterlin
(1)
,
Amandine Le Bourgeois
(1)
,
Sophie Vantyghem
(1, 3)
,
Mourad Tiab
(4)
,
Pascal Godmer
(5)
,
Sophie Sadot
(6)
,
Marion Loirat
(7)
,
Adrien Trebouet
(8)
,
Nicolas Cormier
(1)
,
Steven Le Gouill
(9, 1, 3, 10)
,
Philippe Moreau
(11, 1, 3, 10)
,
Cyrille Touzeau
(9, 1, 3, 10)
1
Hôtel-Dieu de Nantes
2 Etablissement Français du Sang [Nantes]
3 UFR MEDECINE - Université de Nantes - UFR de Médecine et des Techniques Médicales
4 CH La Roche sur Yon
5 CH de Vannes
6 Hôpital privé du Confluent [Nantes]
7 CH de Saint-Nazaire
8 CH Lorient - Centre Hospitalier de Lorient
9 CRCINA-ÉQUIPE 10 - Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma
10 SIRIC-ILIAD - Site de Recherche Intégrée sur le Cancer - Imaging and Longitudinal Investigations to Ameliorate Decision-making
11 CRCINA-ÉQUIPE 11 - Integrative Oncogenomics of Multiple Myeloma Pathogenesis and Progression
2 Etablissement Français du Sang [Nantes]
3 UFR MEDECINE - Université de Nantes - UFR de Médecine et des Techniques Médicales
4 CH La Roche sur Yon
5 CH de Vannes
6 Hôpital privé du Confluent [Nantes]
7 CH de Saint-Nazaire
8 CH Lorient - Centre Hospitalier de Lorient
9 CRCINA-ÉQUIPE 10 - Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma
10 SIRIC-ILIAD - Site de Recherche Intégrée sur le Cancer - Imaging and Longitudinal Investigations to Ameliorate Decision-making
11 CRCINA-ÉQUIPE 11 - Integrative Oncogenomics of Multiple Myeloma Pathogenesis and Progression
Benoit Tessoulin
- Fonction : Auteur
- PersonId : 1040919
- ORCID : 0000-0001-7600-3329
- IdRef : 195047265
Patrice Chevallier
- Fonction : Auteur
- PersonId : 762210
- ORCID : 0000-0003-3142-5581
Thierry Guillaume
- Fonction : Auteur
- PersonId : 766700
- ORCID : 0000-0001-5482-8565
Pierre Peterlin
- Fonction : Auteur
- PersonId : 776625
- ORCID : 0000-0001-5463-6686
Steven Le Gouill
- Fonction : Auteur
- PersonId : 761203
- ORCID : 0000-0001-9840-2128
Philippe Moreau
- Fonction : Auteur
- PersonId : 759214
- ORCID : 0000-0003-1780-8746
Cyrille Touzeau
- Fonction : Auteur
- PersonId : 778761
- ORCID : 0000-0003-0275-2575
Résumé
Triplet-drug regimen bortezomib-thalidomide-dexamethasone (VTD) and bortezomib-lenalidomide-dexamethasone (VRD) are considered as standard of care induction prior autologous stem-cell transplantation (ASCT) in myeloma. In addition to improve response rate, induction therapy should preserve an adequate stem-cell collection. In the present retrospective study, we analyzed stem-cell collection in 325 newly diagnosed myeloma patients who received either VTD or VRD induction before ASCT. Stem-cell mobilization consisted of intravenous cyclophosphamide plus G-CSF. Plerixafor was administered preemptively to rescue mobilization. In comparison with VTD, VRD induction was associated with a more frequent use of plerixafor (19.3% versus 5.4%, p = 0.004) and with an increased number of apheresis to reach adequate collection (>2 apheresis required in 42.3% versus 30.2%, p = 0.05). Moreover, more patients experienced collection failure in the VRD group (6% versus 1.8%, p = 0.004). The median number of CD34-positive cells (×106/kg) was lower in the VRD group: 8.5 versus 9.3 (p = 0.05) in the VTD group. The vast majority of patients underwent ASCT (93% versus 98%, in VRD and VTD group, respectively). These data highlight the need of optimal stem-cell collection strategy, especially in the context of tandem transplantation and incorporation of anti-CD38 monoclonal antibody into induction.