Improved mobilization of peripheral blood CD34+ cells and dendritic cells by AMD3100 plus granulocyte-colony-stimulating factor in non-Hodgkin's lymphoma patients.
AMD3100 is a drug capable of mobilizing peripheral blood stem cells (PBSCs) in donors and in cancer patients as a single agent or in combination with granulocyte-colony-stimulating factor (G-CSF). We initiated a phase II study of 11 refractory or relapsed non-Hodgkin's lymphoma (NHL) patients, receiving 16 microg/kg daily of G-CSF for 4 days followed by 240 microg/kg of AMD3100 given subcutaneously on a new schedule of 9-10 h before apheresis collection on day 5. Our aims were to assess the effect of AMD3100 on the mobilization of CD34+ cells, dendritic cells (DCs) and lymphoma cells. Administration of G-CSF and AMD3100 were continued daily until >or=2 x 10(6) CD34+ cells/kg were collected. Adequate collection of the target of CD34+ cells was achieved in all but 1 patient within 2 days, and 10/11 patients were transplanted within 2 months. All transplanted patients engrafted with a mean of 10 and 12 days for neutrophils and platelets, respectively. Addition of AMD3100 to G-CSF resulted with >2.5-fold increase in CD34+ cells/microl (p = 0.0001) and in a >2-fold increase in pDC1 and pDC2 cells/microl (p = 0.003). Adverse events related to AMD3100 were minimal. AMD3100 was generally safe and improved PBSC and DC cell mobilization with no apparent contamination of lymphoma cells.
Gazitt
Yair
Y
The University of Texas Health Science Center at San Antonio and Audie L Murphy Memorial Veterans Hospital, San Antonio, TX 78284, USA. gazitt@uthscsa.edu
Freytes
Cesar O
CO
Akay
Cagla
C
Badel
Karin
K
Calandra
Gary
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D018952:Antigens, CD34 / Q000097:blood*; D001596:Benzylamines; D000080027:Cyclams; D003713:Dendritic Cells / Q000187:drug effects / Q000502:physiology*; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000502:physiology*; D006571:Heterocyclic Compounds / Q000494:pharmacology*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009504:Neutrophils / Q000637:transplantation; D018579:Patient Selection; D019718:Receptors, CXCR4 / Q000037:antagonists & inhibitors; D012008:Recurrence; D014021:Tissue Preservation / Q000379:methods; D019172:Transplantation Conditioning; D016896:Treatment Outcome