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.
Pozotrigo M, et al. Bone Marrow Transplant. 2013 Jan 21.