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- W2095201468 abstract "Bortezomib (Velcade) is a selective inhibitor of the 26S proteasome approved for the treatment of relapsed or refractory multiple myeloma (MM). The role of bortezomib in front-line therapy for MM is undefined and will depend in part on its effects on subsequent stem cell mobilization and engraftment. We conducted a pilot study of bortezomib administered pretransplantation followed by high-dose melphalan with autologous hematopoietic stem cell transplantation (AHSCT). Two cycles of bortezomib 1.3 mg/m2 were administered on days 1, 4, 8, and 11 of a 21-day treatment cycle. One week after completion of bortezomib, stem cells were mobilized with G-CSF 10 μg/kg/day for 5 days and harvested by large-volume apheresis (20 L/day) until a minimum of 2.5× 106 CD34+ cells/kg were collected. Melphalan 100 mg/m2/day for 2 days was administered, followed by reinfusion of peripheral blood stem cells 48 hours later. GM-CSF 250 μg/m2/day was given posttransplantation until neutrophil engraftment occurred. To date, 32 of a planned 40 patients have been enrolled in this study, with 23 patients having completed their initial therapy with bortezomib followed by AHSCT. Prior therapy included both anthracycline-containing regimens (in 21 patients) and thalidomide-containing regimens (in 14 patients). Two patients had not received prior chemotherapy. All patients successfully achieved the target of 2.5× 106 CD34+ cells/kg in either 1 (17 of 23 patients) or 2 (6 of 23 patients) collections, with the first apheresis product containing a mean of 5.52× 106 CD34+ cells/kg. Analysis of lymphocyte subsets by peripheral blood flow cytometry demonstrated no significant differences before and after treatment with bortezomib. All patients successfully engrafted with a median time to neutrophil engraftment (ANC≥ 500/mm3) of 11 days (range, 9–14 days). Platelet engraftment (time to platelet count≥ 20,000/mm3 sustained for 7 days without transfusion) occurred at a median of 11 days (range, 9–30 days). Seventeen patients were evaluable for response at 100 days posttransplantation. Compared with pre-bortezomib paraprotein levels, 5 patients achieved a CR or near CR, 11 maintained a PR, and 1 patient developed PD. We conclude that pretransplantation treatment with 2 cycles of bortezomib given in sequence after anthracycline- or thalidomide-containing chemotherapy does not adversely affect stem cell yield or time to engraftment in patients with MM undergoing AHSCT." @default.
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- W2095201468 date "2005-02-01" @default.
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- W2095201468 title "Bortezomib does not adversely affect stem cell mobilization and engraftment in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation" @default.
- W2095201468 doi "https://doi.org/10.1016/j.bbmt.2004.12.228" @default.
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