A New Method of Mobilization of Hematopoietic Stem Cells in Autologous Stem Cell Transplantation

Background: Plerixafor is a selective and reversible antagonist of CXCR4 chemokine receptor indicated in combination with G-CSF (Granulocyte colony stimulating factor) to release haematopoietic stem cells (HSC) into the peripheral blood for collection and subsequent autologous transplantation for lymphoma and myeloma patients.
Objective: We studied the efficacy of the plerixafor in association with G-CSF in poorly mobilizing patients.
Materials and methods: We performed 11 mobilization procedures using plerixafor in combination with G-CSF in 8 patients with Hodgkin’s lymphoma, 2 patients with non-Hodgkin’s lymphoma and 1 patient with multiple myeloma. The majority of patients have already been heavily pretreated with cytostatic chemotherapy two of them were also treated with radiotherapy. Patients received G-CSF (10 μg/kg/d) for 4 days. On the evening of day 4, they were given plerixafor (0.24 mg/kg) and in the morning we started the apheresis procedures.
Results and discussion: Mobilization with G-CSF and plerixafor was associated with a satisfactory release of CD34+ cells to the peripheral blood as measured 8 hours after plerixafor administration. The final stem cell product contained a median of 3.14 × 106 CD34+ cells/kg (range 1.51–12.1).
Conclusion: Stem cell mobilization with plerixafor and G-CSF provides a solution for majority of patients who were heavily pretreated.