Plerixafor (Mozobil): A Stem Cell-Mobilizing Agent for Transplantation in Lymphoma Patients Predicted to Be Poor Mobilizers - A Pilot Study.

Abstract

Autologous hematopoietic stem cell transplantation is the standard therapy for refractory/relapsed aggressive lymphoma. The initial step of the procedure involves mobilization and collection of hematopoietic stem cells. G-CSF fails to achieve mobilization in 15-25% of lymphoma patients. Plerixafor is a novel CXCR4 antagonist that can promote mobilization. It has been used successfully in patients after the failure of G-CSF. It is reasonable to test whether plerixafor should become the mobilizing agent of choice in patients expected to exhibit difficulties in mobilization. We initiated a study to assess the use of plerixafor as a first-line stem cell mobilizer in 20 elderly or heavily pretreated patients with non-Hodgkin or Hodgkin lymphoma. The minimum defined CD34+ cell dose of ≥2 × 106 cells/kg was achieved by 90% of the patients, and for 83% of them with one apheresis procedure. The target CD34+ dose of ≥5 × 106 cells/kg was achieved by 70% of the patients. The median number of circulating CD34+ cells before and after plerixafor was 14.4 and 42.8 cells/μl, respectively. The post-plerixafor adverse events were mild. All patients promptly engrafted after high-dose chemotherapy treatment. We conclude that plerixafor administration is safe and efficient for upfront mobilization in lymphoma patients predicted to be poor mobilizers.

• Authors: Ivetta Danylesko, Rina Sareli, Nira Varda-Bloom, Ronit Yerushalmi, Noga Shem-Tov, Avichai Shimoni, Arnon Nagler
• Journal: Acta haematologica (Acta Haematol) Vol. 135 Issue 1 Pg. 29-36 ( 2016) ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 26303343 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 S. Karger AG, Basel.

Chemical References

• Anti-HIV Agents
• Benzylamines
• CXCR4 protein, human
• Cyclams
• Heterocyclic Compounds
• Receptors, CXCR4
• plerixafor

Topics

• Adult
• Aged
• Anti-HIV Agents (administration & dosage, adverse effects)
• Autografts
• Benzylamines
• Cyclams
• Female
• Hematopoietic Stem Cell Mobilization (methods)
• Heterocyclic Compounds (administration & dosage, adverse effects)
• Hodgkin Disease (blood, therapy)
• Humans
• Lymphoma, Non-Hodgkin (blood, therapy)
• Male
• Middle Aged
• Peripheral Blood Stem Cell Transplantation
• Pilot Projects
• Receptors, CXCR4 (antagonists & inhibitors)