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Bone Marrow Transplant ; 53(2): 175-179, 2018 02.
Article in English | MEDLINE | ID: mdl-29058701

ABSTRACT

Chemotherapy with G-CSF is used to mobilize peripheral stem cells in multiple myeloma (MM) patients, with plerixafor as a rescue strategy for poorly mobilizing patients. Preclinical studies suggested that the nonsteroidal anti-inflammatory drug meloxicam enhances the mobilization of CD34+ cells. In this single-center study, we evaluated whether adding meloxicam to chemotherapy/G-CSF mobilization increases peripheral hematopoietic CD34+ cell levels and reduces the need of using plerixafor. We prospectively compared two consecutive cohorts of MM patients in first remission mobilized with G-CSF and non-myelosuppressive chemotherapy with vinorelbine or gemcitabine. The second cohort additionally received oral meloxicam. The cohorts comprised 84 patients without meloxicam (-M) and 66 patients with meloxicam (+M). Meloxicam was well tolerated and associated with similar hematologic engraftment after transplantation and equal survival rates. However, the meloxicam group had higher CD34+ cell levels on day 8 of the mobilization procedure (53 200 versus 35 600 CD34+ cells/mL; P=0.007), and fewer patients needed >1 collection day (+M: 6 (9%) patients versus -M: 16 (19%) patients; P=0.04). This resulted in reduced plerixafor administrations (+M: 7 (11%) patients versus -M: 18 (21%) patients; P=0.03) and less costs. Our data suggest that meloxicam enhances the mobilization of hematopoietic CD34+ blood cells in MM patients.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Hematopoietic Stem Cell Mobilization/methods , Meloxicam/therapeutic use , Multiple Myeloma/drug therapy , Multiple Myeloma/surgery , Peripheral Blood Stem Cell Transplantation/methods , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Female , Humans , Male , Meloxicam/pharmacology , Middle Aged , Multiple Myeloma/pathology
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