Impact of prior melphalan exposure on stem cell collection in light chain amyloidosis

Impact of prior melphalan exposure on stem cell collection in light chain amyloidosis BONE MARROW TRANSPLANTATION Sidana, S., Tandon, N., Gertz, M. A., Dispenzieri, A., Buadi, F. K., Lacy, M. Q., Dingli, D., Fonder, A. L., Hayman, S. R., Hobbs, M. A., Gonsalves, W. I., Hwa, Y., Kapoor, P., Kyle, R. A., Leung, N., Go, R. S., Lust, J. A., Russell, S. J., Zeldenrust, S. R., Rajkumar, S., Hogan, W. J., Kumar, S. K. 2018; 53 (3): 326–33

Abstract

Use of melphalan in multiple myeloma was observed to have a deleterious effect on stem cell collection in older studies. There is limited data on the impact of melphalan in light chain (AL) amyloidosis, especially in the plerixafor era. We retrospectively evaluated stem cell mobilization in 610 patients with AL amyloidosis, of which 79 had prior exposure to melphalan, 167 to other chemotherapeutics, while 364 had no chemotherapy exposure. Collection of CD34+ stem cells?×?106/kg was lower in the melphalan group. Median total yields in the melphalan, non-melphalan, and no chemotherapy groups were 5.5, 7.7, and 7.8, respectively; p?150?mg (median: three cycles) resulting in lower yields. Therefore, duration of melphalan exposure prior to stem cell collection should be limited, ideally, not exceeding more than two cycles of treatment.

View details for DOI 10.1038/s41409-017-0020-5

View details for Web of Science ID 000427675200011

View details for PubMedID 29269795