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

Hübel K, Fresen MM, Salwender H, Basara N, Beier R, Theurich S, Christopeit M, Bogner C, Galm O, Hartwig R, Heits F, Lordick F, Rösler W, Wehler D, Zander AR, Albert MH, Dressler S, Ebinger M, Frickhofen N, Hertenstein B, Kiehl M, Liebler S, von Lilienfeld-Toal M, Weidmann E, Weigelt C, Lange F, Kröger N (2011) Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program. Bone Marrow Transplant 46(8), 1045-1052.

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.

Leibniz-HKI-Authors

Marie von Lilienfeld-Toal

Identifier

doi: 10.1038/bmt.2010.249

PMID: 20972470