Treatment With AMD3100 (Plerixafor) in MM Patients to Mobilize PBCs For Collection and for Transplantation

Study Overview
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Brief Summary
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This study will examine whether 240 µg/kg plerixafor given alone for up to 4 days is safe and well tolerated in multiple myeloma (MM) patients. In addition, this study determines if plerixafor alone can be used to mobilize peripheral blood progenitor cells (PBPCs) for transplantation in MM patients. The minimum number of CD34+ cells to collect is 2*10^6 CD34+ cells/kg and the target is ≧4*10^6 CD34+ cells/kg. Success of transplant engraftment will be measured by the number of days to polymorphonuclear leukocytes (PMN) and platelet (PLT) engraftment. Durability of transplant will be assessed for a minimum of one year.

Detailed Description
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This study will examine whether 240 µg/kg plerixafor given alone for up to 4 days is safe and well tolerated in multiple myeloma (MM) patients. In addition, this study determines if 240 µg/kg plerixafor alone can be used to mobilize peripheral blood progenitor cells (PBPCs) for transplantation in MM patients. The minimum number of CD34+ cells to collect is 2*10^6 CD34+ cells/kg and the target is ≧4*10^6 CD34+ cells/kg. Success of transplant engraftment will be measured by the number of days to polymorphonuclear leukocytes (PMN) and platelet (PLT) engraftment. Durability of engraftment will be assessed for a minimum of one year. This study was previously posted by AnorMED, Inc. In November 2006, AnorMED, Inc. was acquired by Genzyme Corporation. Genzyme Corporation is the sponsor of the trial.

Official Title
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Treatment With AMD3100 in Multiple Myeloma Patients to Mobilize Peripheral Blood Progenitor Cells For Collection and for Transplantation

Conditions
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Multiple Myeloma

Intervention / Treatment
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* Drug: plerixafor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of multiple myeloma (MM) Eligible for autologous transplantation Patients in first or second partial remission (PR) or complete remission (CR) Patients who have received ≦2000 rads of prior radiation therapy Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Recovered from all acute toxic effects of prior chemotherapy White blood cells (WBC) >3.0*10^9/l Absolute polymorphonuclear leucocyte (PMN) count >1.5*10^9/l Platelet (PLT) count > 150*10^9/l Serum creatinine ≦2.2 mg/dl Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and total bilirubin <2 x upper limit of normal (ULN) Negative for HIV Signed informed consent Patients of childbearing potential agree to use an approved form of contraception Exclusion Criteria: Patient received 2 or more alkylating agents, such as VBMCP (a combination of Vincristine, BCNU (Bis-Chloronitrosourea), Melphalan, Cyclophosphamide, and Prednisone) Patient received a total dose of ≧200 mg of prior melphalan A co-morbid condition which, in the view of the investigators, renders the patient at high risk from treatment complications Patient has failed previous collections or collection attempts A residual acute medical condition resulting from prior chemotherapy Brain metastases or carcinomatous meningitis Acute infection Fever (temperature >38 °C / 100.4 °F) Hypercalcemia (>1mg/dl above ULN) Positive pregnancy test in female patients Lactating females Patients of childbearing potential unwilling to implement adequate birth control Patients whose actual body weight exceeds 175% of their ideal body weight History of ventricular arrhythmias Patient received thalidomide within 10 days prior to receiving the first dose of plerixafor Patients who previously received experimental therapy within 4 weeks of enrolling in this protocol or who are currently enrolled in another experimental protocol during the mobilization phase

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Participants with Multiple Myeloma (MM)<br>Participants with MM who were eligible for autologous peripheral blood stem cell transplantation. | Drug: plerixafor<br>* Participants were given a 240 µg/kg dose of plerixafor by subcutaneous injection in the morning followed by apheresis 6 hours later. Daily treatment with plerixafor followed by apheresis was administered for up to 4 consecutive days or until 4*10^6 CD34+ cells/kg body weight had been collected.<br>* Other names: AMD3100;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants Who Achieved ≥4*10^6 CD34+ Cells/kg | Number of participants achieving a target of ≥ 4*10^6 CD34+ cells/kg during apheresis for up to 4 consecutive days. Apheresis was performed six hours following treatment with plerixafor 240 µg/kg (alone). Target was calculated as the sum of all daily values collected from central laboratory data over up to 4 apheresis days. | Day 1 up to day 4 | 
| Participant Counts of Summarized Adverse Events (AE) During Treatment | Participant counts of summarized adverse events (AEs) which occurred from the first dose of plerixafor up to the day prior to chemotherapy/ablative treatment. Events were graded according to World Health Organization criteria: Mild (awareness of sign or symptom, but easily tolerated), Moderate (discomfort enough to cause interference with usual activity), Severe (incapacitating with inability to work or do usual activity). | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Transplantations That Achieved Polymorphonuclear Leukocyte (PMN) Engraftment Grouped by Days to Engraftment | Polymorphonuclear cell (PMN) engraftment was defined as a PMN count ≥ 0.5*10^9/L for 3 consecutive days or ≥ 1*10^9/L for 1 day. Days to engraftment corresponded to the first day that the criteria were met after transplantation. | Approximately 2 months | 
| Number of Transplantations That Achieved Platelet (PLT) Engraftment Grouped by Days to Engraftment | Platelet (PLT) engraftment was defined as a PLT count of ≥ 20*10^9/L for 7 days without transfusion. Days to engraftment corresponded to the first day that the criteria were met after transplantation. | Approximately 2 months | 
| Number of Participants With a Durable Graft at 12 Months Post Transplantation | Graft durability was assessed by the Investigator based on complete blood count (CBC) and differential analyses at 12 months post transplantation. | Approximately month 13 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multiple Myeloma, Stem cell mobilization, apheresis