European data on stem cell mobilization with plerixafor in patients with nonhematologic diseases: an analysis of the European consortium of stem cell mobilization.

Abstract

BACKGROUND:

Plerixafor with granulocyte-colony-stimulating factor (G-CSF) has been shown to enhance stem cell mobilization in patients with multiple myeloma and lymphoma with previous mobilization failure. In this European named patient program we report the experience in insufficiently mobilizing patients diagnosed with nonhematologic diseases.

STUDY DESIGN AND METHODS:

Thirty-three patients with germ cell tumor (n=11), Ewing sarcoma (n=6), Wiscott-Aldrich disease (n=5), neuroblastoma (n=4), and other nonhematologic diseases (n=7) were included in the study. Plerixafor was limited to patients with previous or current stem cell mobilization failure and given after 4 days of G-CSF (n=21) or after chemotherapy and G-CSF (n=12) in patients who mobilized poorly.

RESULTS:

Overall, 28 (85%) patients succeeded in collecting at least 2×10(6)/kg body weight (b.w.) CD34+ cells (median, 5.0×10(6)/kg b.w. CD34+ cells; range, 2.0×10(6)-29.5×10(6)/kg b.w. CD34+ cells), and five (15%) patients collected a median of 1.5×10(6)/kg b.w. CD34+ cells (range, 0.9×10(6)-1.8×10(6)/kg b.w. CD34+ cells). Nineteen patients proceeded to transplantation. The median dose of CD34+ cells infused was 3.3×10(6)/kg b.w. (range, 2.3×10(6)-6.7×10(6)/kg b.w. CD34+ cells). The median numbers of days to neutrophil and platelet engraftment were 11 (range, 9-12) and 15 (range, 10-25) days, respectively.

CONCLUSION:

These data emphasize the role of plerixafor in combination with G-CSF or chemotherapy and G-CSF as an effective mobilization regimen with the potential of successful stem cell collection. Accordingly, plerixafor seems to be safe and effective in patients with nonhematologic diseases. Larger prospective studies are warranted to further assess its use in these patients.

• Authors: Nina Worel, Jane F Apperley, Grzegorz W Basak, Kenneth W Douglas, Ian H Gabriel, Catarina Geraldes, Kai Hübel, Ozren Jaksic, Zdenek Koristek, Francesco Lanza, Roberto Lemoli, Gabor Mikala, Dominik Selleslag, Rafael F Duarte, Mohamad Mohty
• Journal: Transfusion (Transfusion) Vol. 52 Issue 11 Pg. 2395-400 (Nov 2012) ISSN: 1537-2995 [Electronic] United States
• PMID: 22414093 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 American Association of Blood Banks.

Chemical References

• Anti-HIV Agents
• Antineoplastic Agents
• Benzylamines
• Cyclams
• Heterocyclic Compounds
• Granulocyte Colony-Stimulating Factor
• plerixafor

Topics

• Adolescent
• Adult
• Aged
• Anti-HIV Agents (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Benzylamines
• Blood Component Removal (methods)
• Bone Neoplasms (drug therapy)
• Child
• Child, Preschool
• Combined Modality Therapy
• Cyclams
• Europe
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Hematopoietic Stem Cell Mobilization (methods)
• Heterocyclic Compounds (therapeutic use)
• Humans
• Male
• Middle Aged
• Neoplasms (drug therapy)
• Neoplasms, Germ Cell and Embryonal (drug therapy)
• Neuroblastoma (drug therapy)
• Sarcoma, Ewing (drug therapy)
• Stem Cell Transplantation (methods)
• Wiskott-Aldrich Syndrome (drug therapy)
• Young Adult