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Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience

Abstract : 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.
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https://www.hal.inserm.fr/inserm-03495985
Contributor : Elizabeth Bernardo Connect in order to contact the contributor
Submitted on : Monday, December 20, 2021 - 1:36:31 PM
Last modification on : Wednesday, April 27, 2022 - 3:57:19 AM

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Vanille Laurent, Clémentine Fronteau, Chloé Antier, Pascale Dupuis, Benoit Tessoulin, et al.. Autologous stem-cell collection following VTD or VRD induction therapy in multiple myeloma: a single-center experience. Bone Marrow Transplantation, Nature Publishing Group, 2021, 56 (2), pp.395-399. ⟨10.1038/s41409-020-01033-8⟩. ⟨inserm-03495985⟩

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