AMD3100 plus G-CSF can successfully mobilize CD34+ cells from non-Hodgkin's lymphoma, Hodgkin's disease and multiple myeloma patients previously failing mobilization with chemotherapy and/or cytokine treatment: compassionate use data.
AMD3100 given with G-CSF has been shown to mobilize CD34+ cells in non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), and Hodgkin's disease (HD) patients who could not collect sufficient cells for autologous transplant following other mobilization regimens. These poor mobilizers are usually excluded from company-sponsored trials, but have been included in an AMD3100 Single Patient Use protocol, referred to as a Compassionate Use Protocol (CUP). A cohort of 115 data-audited poor mobilizers in CUP was assessed, with the objective being to collect > or =2 x 10(6) CD34+ cells per kg following AMD3100 plus G-CSF mobilization. The rates of successful CD34+ cell collection were similar for patients who previously failed chemotherapy mobilization or cytokine-only mobilization: NHL -- 60.3%, MM -- 71.4% and HD -- 76.5%. Following transplant, median times to neutrophil and PLT engraftment were 11 days and 18 days, respectively. Engraftment was durable. There were no drug-related serious adverse events. Of the adverse events considered related to AMD3100, two (1.6%) were severe (one patient -- headache, one patient -- nightmares). Other AMD3100-related adverse events were mild (84.8%) or moderate (13.6%). The most common AMD3100-related adverse events were gastrointestinal reactions, injection site reactions and paresthesias. AMD3100 plus G-CSF offers a new treatment to collect CD34+ cells for autologous transplant from poor mobilizers, with a high success rate.
Calandra
G
G
AnorMED Corp of Genzyme Corp, Langley, British Columbia, Canada. gcalandra@anormed.com
McCarty
J
J
McGuirk
J
J
Tricot
G
G
Crocker
S-A
SA
Badel
K
K
Grove
B
B
Dye
A
A
Bridger
G
G
D000328:Adult; D000368:Aged; D018952:Antigens, CD34; D001596:Benzylamines; D003115:Colony-Stimulating Factors / Q000627:therapeutic use*; D000080027:Cyclams; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016879:Salvage Therapy / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods
D018952:Antigens, CD34; D001596:Benzylamines; D003115:Colony-Stimulating Factors; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor