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Bortezomib washout duration prior to stem cell mobilization in patients with newly diagnosed multiple myeloma
Author(s) -
Luttwak Efrat,
Amit Odelia,
Avivi Irit,
Trestman Svetlana,
Eshel Rinat,
Cohen Yael C.,
Ram Ron
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13404
Subject(s) - bortezomib , medicine , multiple myeloma , prospective cohort study , autologous stem cell transplantation , oncology , cd34 , receiver operating characteristic , urology , surgery , stem cell , biology , genetics
Objectives We aimed to determine the impact of washout period in patients with multiple myeloma between bortezomib‐based induction regimens and the collection of stem cells. Methods This was a single‐center historical prospective study, including all sequential newly diagnosed patients with myeloma between 2012 and 2017 that were given a first‐line bortezomib‐based induction therapy (≤6 cycles) followed by stem cell collection (n = 75). Results We found a statistically significant correlation between the days from last dose of bortezomib and both CD34 + cells/kg yield on the first collection day and the overall collected CD34 + cells/kg ( r  = .466, P  < .001, and r  = .341, P  = .03, respectively). The optimal receiver operating curve's cutoff point was 8.5 days (79% sensitivity and 71% specificity, P  = .001). On multivariate analysis, timing of last dose of bortezomib remained statistically significant ( P  = .01). Based on this, we developed a model to predict the total collected CD34 + cells/kg = 11.76 + 0.13 (timing in days of last dose of bortezomib) −0.1 (age) −1.39 (if female) −0.01 (≥PR) −1.35 (if prior radiation). Conclusions Timing of last dose of bortezomib may predict a successful collection. A washout period of 9 days is associated with a better collection yield. A prospective validation of this novel finding is required.

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