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

Autor: Keller S Seipel K Novak U Mueller BU Taleghani BM Leibundgut K Pabst T.
Rok vydání: 2015
Předmět:
Zdroj: Leuk Res
Popis: 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.
Databáze: OpenAIRE