Myeloma
treatments require a heavy artillery of novel myeloma drugs to reduce the
number of cancer cells (ex: Revlimid, Velcade, or Thalomid), followed by
high-dose chemotherapy to wipe out the cancer. Because the latter can completely
wipe out blood-forming stem cells (a side effect that can be life-threatening
to the patient), clinicians quickly learned to collect patient stem cells right
before high-dose chemotherapy, and then transplanting them back into patients
after treatment. The feasibility of this approach depends on the effects of
myeloma drugs on patient stem cells.
In contrast
to the previous report that Revlimid can negatively impact the success of
patient stem cell collection, a 10-year retrospective study at the Memorial
Sloan-Kettering Cancer Center showed that the negative impact of Revlimid can
be corrected with stem cell boosting treatments. In the paper published in January
2013 issue of Bone Marrow Transplantation,
the researchers reported that the Revlimid-based regimen had little impact on
the success of patient stem cell collection; a conclusion based on the majority
of myeloma patients who have received stem cell boosting treatments such as granulocyte-colony
stimulating factor (G-CSF) combined with cyclophosphamide (Cytoxan)
The study strongly
suggests that stem cell boosting agents can overcome the negative influences of
Revlimid on patient stem cell collection. However, whether Revlimid itself can
affect the viability of patient stem cells is a question that still remains
unanswered.
Reference:
Pozotrigo
M, et al. Bone Marrow Transplant. 2013 Jan 21.
