eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
5/2018
vol. 14
 
Share:
Share:
more
 
 
abstract:
Clinical research

Impact of lenalidomide exposure on blood cell collection for autotransplants in persons with POEMS syndrome

Hao Cai, Jiefei Bai, Jian Li, Huacong Cai, Minghui Duan, Xinxin Cao, Miao Chen, Daobin Zhou, Wei Zhang

Arch Med Sci 2018; 14, 5: 1048–1054
Online publish date: 2016/11/02
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Lenalidomide is an effective therapy of POEMS syndrome. However, there is concern that exposure to lenalidomide may reduce the efficiency of blood cell collection in persons who may eventually receive an autotransplant. We studied the impact of lenalidomide therapy on subsequent blood cell mobilization and collection including frequency of blood CD34+ cells and CXCR4 expression before and after mobilization with cyclophosphamide and granulocyte-colony stimulating factor (G-CSF).

Material and methods
Forty-three subjects with POEMS were assigned to receive lenalidomide and dexamethasone for 2–4 28 d cycles (n = 19) or no therapy (n = 24). All subjects then received cyclophosphamide and G-CSF. Neither cohort had substantial numbers of blood CD34+ cells before mobilization.

Results
Mobilization increased blood CD34+ frequency in lenalidomide-treated subjects and controls similarly (0.25% (95% confidence interval (CI): 0.03–1.39% vs. 0.32%, 0.04–1.47%), p = 0.472). Increases in blood CD34+ numbers were also similar (10 × 106/l) (5–77 × 106/l) vs. 14 × 106/l (6–101 × 106/l), p = 0.312). Mean CXCR4 fluorescence intensity on bone marrow cells from controls decreased from 58 ±34 (mean ± SD) to 31 ±16 after mobilization (p = NS). In contrast, mean CXCR4 intensity on bone marrow cells in lenalidomide-treated subjects increased from 55 ±43 to 89 ±40 (p = 0.017, comparing the deviation between two groups). Median numbers of CD34+ cells collected in lenalidomide-treated subjects and controls were 2.3 × 106/kg (0.6–6.8 × 106/kg) and 2.8106/kg (1.0–8.9 × 106/kg; p = 0.521).

Conclusions
Brief lenalidomide treatment for POEMS did not reduce numbers of CD34+ blood cells collected but increased CXCR4 expression on bone marrow CD34+ cells.

keywords:

POEMS syndrome, lenalidomide, blood cell collection, mobilization

references:
Dispenzieri A. POEMS syndrome. Blood Rev 2007; 21: 285-99.
D’Souza A, Hayman SR, Buadi F, et al. Utility of plasma vascular endothelial growth factor levels in the diagnosis and follow-up of patients with POEMS syndrome. Blood 2011; 118: 4663-5.
Dispenzieri A, Moreno-Aspitia A, Suarez GA, et al. Peripheral blood stem cell transplantation in 16 patients with POEMS syndrome, and a review of the literature. Blood 2004; 104: 3400-7.
Nakaseko C. Autologous stem cell transplantation for POEMS syndrome. Clin Lymphoma Myeloma Leuk 2014; 14: 21-3.
Xiong T, Chen X, Wei H, et al. Influence of PJ34 on the genotoxicity induced by melphalan in human multiple myeloma cells. Arch Med Sci 2015; 11: 301-6.
Li J, Zhang W, Duan MH, et al. PBSC mobilization in newly diagnosed patients with POEMS syndrome: outcomes and prognostic factors. Bone Marrow Transplantation 2013; 48: 233-7.
Lestang E, Caristan A, Neel A, et al. Lenalidomide as frontline therapy in POEMS syndrome: a retrospective case series of 8 patients. Leuk Lymphoma 2015; 56: 1895-6.
Semeraro M, Vacchelli E, Eggermont A, et al. Trial Watch: lenalidomide based immunochemotherapy. Oncoimmunology 2013; 2: e26494.
Royer B, Merlusca L, Abraham J, et al. Efficacy of lenalidomide in POEMS syndrome: a retrospective study of 20 patients. Am J Hematol 2013; 88: 207-12.
McDaniel JM, Pinilla-Ibarz J, Epling-Burnette PK. Molecular action of lenalidomide in lymphocytes and hematologic malignancies. Adv Hematol 2012; 2012: 513702.
Mazumder A, Kaufman J, Niesvizky R, Lonial S, Vesole D, Jagannath S. Effect of lenalidomide therapy on mobilization of peripheral blood stem cells in previously untreated multiple myeloma patients. Leukemia 2008; 22: 1280-1.
Kumar S, Dispenzieri A, Lacy MQ, et al. Impact of lenalidomide therapy on stem cell mobilization and engraftment postperipheral blood stem cell transplantation in patients with newly diagnosed myeloma. Leukemia 2007; 21: 2035-42.
Pal R, Monaghan SA, Hassett AC, et al. Immunomodulatory derivatives induce PU.1 down-regulation, myeloid maturation arrest, and neutropenia. Blood 2010; 115: 605-14.
Koh KR, Janz M, Mapara MY, et al. Immunomodulatory derivative of thalidomide (IMiD CC-4047) induces a shift in lineage commitment by suppressing erythropoiesis and promoting myelopoiesis. Blood 2005; 105: 3833-40.
Li S, Fu J, Ma H, Mapara MY, Lentzsch S. Lenalidomide-induced upregulation of CXCR4 in CD34+ hematopoietic cells, a potential mechanism of decreased hematopoietic progenitor mobilization. Leukemia 2013; 27: 1407-11.
Dispenzieri A, Kyle RA, Lacy MQ, et al. POEMS syndrome: definitions and long-term outcome. Blood 2003; 101: 2496-506.
Dispenzieri A. POEMS syndrome: 2014 update on diagnosis, risk-stratification, and management. Am J Hematol 2014; 89: 214-23.
Ghosh MC, Baatar D, Collins G, et al. Dexamethasone augments CXCR4-mediated signaling in resting human T cells via the activation of the Src kinase Lck. Blood 2009; 113: 575-84.
FEATURED PRODUCTS
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe