The addition of plerixafor is safe and allows adequate PBSC collection in multiple myeloma and lymphoma patients poor mobilizers after chemotherapy and G-CSF.
We report 13 multiple myeloma (MM) or lymphoma patients who were failing PBSC mobilization after disease-specific chemotherapy and granulocyte-CSF (G-CSF), and received plerixafor to successfully collect PBSCs. Patients were considered poor mobilizers when the concentration of PB CD34(+) cells was always lower than 10 cells/μL, during the recovery phase after chemotherapy and/or were predicted to have inadequate PBSC collection to proceed to autologous transplantation. Plerixafor (0.24 mg/kg) was administered subcutaneously for up to three consecutive days, while continuing G-CSF, 10-11 h before the planned leukapheresis. Plerixafor administration was safe and no significant adverse events were recorded. We observed a 4.7 median fold-increase in the number of circulating CD34(+) cells after plerixafor as compared with baseline CD34(+) cell concentration (from a median of 6.2 (range 1-12) to 21.5 (range 9-88) cells/μL). All patients collected >2 × 10(6) CD34(+) cells/kg in 1-3 leukaphereses. In all, 5/13 patients have already undergone autograft with plerixafor-mobilized PBSCs, showing a rapid and durable hematological recovery. Our results suggest that the pre-emptive addition of plerixafor to G-CSF after chemotherapy is safe and may allow the rescue of lymphoma and MM patients, who need autologous transplantation but are failing PBSC mobilization.
D'Addio
A
A
Department of Hematology and Oncological Sciences L and A Seràgnoli, Institute of Hematology, University of Bologna and Stem Cell Research Center, S Orsola-Malpighi Hospital, Bologna, Italy.
Curti
A
A
Worel
N
N
Douglas
K
K
Motta
M R
MR
Rizzi
S
S
Dan
E
E
Taioli
S
S
Giudice
V
V
Agis
H
H
Kopetzky
G
G
Soutar
R
R
Casadei
B
B
Baccarani
M
M
Lemoli
R M
RM
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000096:biosynthesis; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D000080027:Cyclams; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D008223:Lymphoma / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor