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

Phase 2

Terminated

Brief Summary: 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: 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.

Recruitment & Eligibility

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

Arm && Interventions

Group	Intervention	Description
Participants with Multiple Myeloma (MM)	plerixafor	Participants with MM who were eligible for autologous peripheral blood stem cell transplantation.

Primary Outcome Measures

Name	Time	Method
Number of Participants Who Achieved ≥4*10^6 CD34+ Cells/kg	Day 1 up to day 4	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.
Participant Counts of Summarized Adverse Events (AE) During Treatment	1 month	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).

Secondary Outcome Measures

Name	Time	Method
Number of Transplantations That Achieved Polymorphonuclear Leukocyte (PMN) Engraftment Grouped by Days to Engraftment	Approximately 2 months	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.
Number of Transplantations That Achieved Platelet (PLT) Engraftment Grouped by Days to Engraftment	Approximately 2 months	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.
Number of Participants With a Durable Graft at 12 Months Post Transplantation	Approximately month 13	Graft durability was assessed by the Investigator based on complete blood count (CBC) and differential analyses at 12 months post transplantation.

Locations (2): Memorial Sloan-Kettering Cancer Center
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New York, New York, United States
Thomas Jefferson University
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Philadelphia, Pennsylvania, United States