Impairment of filgrastim-induced stem cell mobilization after prior lenalidomide in patients with multiple myeloma.


Journal Article

Lenalidomide is an agent that has shown great activity in patients with multiple myeloma (MM). However, studies have suggested that this drug negatively affects subsequent stem cell collection. To investigate whether lenalidomide impairs stem cell mobilization and collection, we reviewed data for patients with MM who underwent mobilization with filgrastim. Predictors of mobilization failure were evaluated using logistic regression analysis. In 26 (9%) of 302 myeloma patients, stem cell mobilization failed. Mobilization failed in 25% of patients who had previously received lenalidomide, compared with 4% of patients who had not received lenalidomide (P < .001). In a multivariate analysis, prior lenalidomide use (odds ratio: 5.9; 95% confidence interval [CI]: 2.4-14.3) and mobilization more than 1 year after diagnosis (odds ratio: 4.6; 95% CI: 1.9-11.1) were significantly associated with failed mobilization. Twenty-one of 26 patients in whom mobilization with filgrastim failed underwent remobilization with chemotherapy and filgrastim; in 18 (86%) of these 21 patients, stem cells were successfully mobilized and collected. In patients with multiple myeloma, prior lenalidomide therapy is associated with failure of stem cell mobilization with filgrastim. Remobilization with chemotherapy and filgrastim is usually successful in these patients.

Full Text

Duke Authors

Cited Authors

  • Popat, U; Saliba, R; Thandi, R; Hosing, C; Qazilbash, M; Anderlini, P; Shpall, E; McMannis, J; Körbling, M; Alousi, A; Andersson, B; Nieto, Y; Kebriaei, P; Khouri, I; de Lima, M; Weber, D; Thomas, S; Wang, M; Jones, R; Champlin, R; Giralt, S

Published Date

  • June 2009

Published In

Volume / Issue

  • 15 / 6

Start / End Page

  • 718 - 723

PubMed ID

  • 19450756

Pubmed Central ID

  • 19450756

Electronic International Standard Serial Number (EISSN)

  • 1523-6536

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2009.02.011


  • eng

Conference Location

  • United States