Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program

Bone Marrow Transplant. 2011 Aug;46(8):1045-52. doi: 10.1038/bmt.2010.249. Epub 2010 Oct 25.

Abstract

The CXCR4-inhibitor plerixafor mobilizes hematopoietic stem cells amplifying the effects of granulocyte-CSF (G-CSF). Before approval plerixafor was used in a compassionate use program (CUP) for patients who failed a previous mobilization. In the German CUP 60 patients from 23 centers (median age 56.5 years (2-75)) were given 240 μg/kg plerixafor SC 9-11 h before apheresis. A total of 78.3% (47/60) received G-CSF for 4 days before plerixafor administration; 76.6% of those (36/47) yielded at least 2.0 × 10(6) CD34(+) cells/μL. The median cell yield was 3.35 × 10(6) CD34+ cells/kg (0-29.53). Nine patients received plerixafor alone or with G-CSF for less than 4 days mobilizing a median of 3.30 × 10(6) CD34+ cells/kg (1.6-5.6). There was no significant difference between G-CSF application for 4 days and for a shorter period of time (P=0.157). A total of 47 patients received plerixafor plus G-CSF combined with chemotherapy yielding a median of 3.28 × 10(6) CD34+ cells/kg (0-24.79). In all, 40 of 60 patients (66.7%) proceeded to transplantation, and achieved a timely and stable engraftment. Side effects were rare and manageable. In conclusion, mobilization with plerixafor in poor mobilizers is safe and results in a sufficient stem cell harvest in the majority of patients.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Benzylamines
  • Blood Component Removal / methods
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Compassionate Use Trials*
  • Cyclams
  • Female
  • Germany
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematopoietic Stem Cell Mobilization / methods*
  • Hematopoietic Stem Cell Transplantation / methods
  • Heterocyclic Compounds / adverse effects
  • Heterocyclic Compounds / therapeutic use*
  • Hodgkin Disease / blood
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / surgery
  • Hodgkin Disease / therapy*
  • Humans
  • Lymphoma, Non-Hodgkin / blood
  • Lymphoma, Non-Hodgkin / drug therapy
  • Lymphoma, Non-Hodgkin / surgery
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / blood
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / surgery
  • Multiple Myeloma / therapy*
  • Treatment Outcome
  • Young Adult

Substances

  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • Granulocyte Colony-Stimulating Factor
  • plerixafor