Neurotoxicity of stem cell mobilization chemotherapy with vinorelbine in myeloma patients after bortezomib treatment.

Keller, Sandra; Seipel, Katja; Novak, Urban; Mueller, Beatrice U; Mansouri Taleghani, Behrouz; Leibundgut, Kurt; Pabst, Thomas (2015). Neurotoxicity of stem cell mobilization chemotherapy with vinorelbine in myeloma patients after bortezomib treatment. Leukemia research, 39(7), pp. 786-792. Elsevier 10.1016/j.leukres.2015.03.015

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Vinorelbine chemotherapy with G-CSF stimulation is the standard mobilization regimen in Switzerland for multiple myeloma patients. However, with the increasing use of bortezomib during induction treatment, adding the neurotoxic compound vinorelbine for mobilization may aggravate bortezomib-induced polyneuropathy. In this retrospective single-center study, we aimed to explore vinorelbine mediated neuropathy in 106 consecutive bortezomib pretreated myeloma patients. We confirmed that vinorelbine with G-CSF represents a reliable and effective regimen for mobilization of autologous stem cells. However, the single administration of 35 mg/m(2) vinorelbine added significant neurotoxicity. We found that 24 patients (24%) reported vinorelbine mediated neurotoxicity: Aggravation of bortezomib-induced neuropathy was observed in 17 patients (17%), and vinorelbine mobilization induced first occurrence of polyneuropathy in additional 7 patients (7%). We observed that development of polyneuropathy was not associated with differing survival rates. Finally, affected patients reported polyneuropathy associated disease burden as "very high" in 13% and "high" in 50%. Our data indicate that a single administration of vinorelbine to mobilize autologous stem cells is associated with significant additional polyneuropathy in bortezomib pretreated myeloma patients. The efficacy of vinorelbine mobilization should be balanced against its neurotoxic potential.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)

UniBE Contributor:

Seipel, Katja; Novak, Urban; Mansouri Taleghani, Behrouz and Pabst, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0145-2126

Publisher:

Elsevier

Language:

English

Submitter:

Marianne Zahn

Date Deposited:

26 Feb 2016 08:34

Last Modified:

12 Sep 2017 06:14

Publisher DOI:

10.1016/j.leukres.2015.03.015

PubMed ID:

25891070

Uncontrolled Keywords:

Bortezomib; Mobilization; Myeloma; Neurotoxicity; Polyneuropathy; Stem cells; Vinorelbine

BORIS DOI:

10.7892/boris.77201

URI:

https://boris.unibe.ch/id/eprint/77201

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