Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program.
The CXCR4-inhibitor plerixafor mobilizes hematopoietic stem cells amplifying the effects of granulocyte-CSF (G-CSF). Before approval plerixafor was used in a compassionate use program (CUP) for patients who failed a previous mobilization. In the German CUP 60 patients from 23 centers (median age 56.5 years (2-75)) were given 240 μg/kg plerixafor SC 9-11 h before apheresis. A total of 78.3% (47/60) received G-CSF for 4 days before plerixafor administration; 76.6% of those (36/47) yielded at least 2.0 × 10(6) CD34(+) cells/μL. The median cell yield was 3.35 × 10(6) CD34+ cells/kg (0-29.53). Nine patients received plerixafor alone or with G-CSF for less than 4 days mobilizing a median of 3.30 × 10(6) CD34+ cells/kg (1.6-5.6). There was no significant difference between G-CSF application for 4 days and for a shorter period of time (P=0.157). A total of 47 patients received plerixafor plus G-CSF combined with chemotherapy yielding a median of 3.28 × 10(6) CD34+ cells/kg (0-24.79). In all, 40 of 60 patients (66.7%) proceeded to transplantation, and achieved a timely and stable engraftment. Side effects were rare and manageable. In conclusion, mobilization with plerixafor in poor mobilizers is safe and results in a sufficient stem cell harvest in the majority of patients.
University Hospital of Cologne, Cologne, Germany. kai.huebel@uni-koeln.de
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Hübel
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Fresen
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Salwender
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Beier
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Theurich
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Christopeit
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Bogner
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Galm
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Hartwig
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Heits
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Lordick
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Rösler
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Wehler
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Zander
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Albert
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Dressler
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Ebinger
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Frickhofen
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Hertenstein
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Kiehl
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Liebler
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von Lilienfeld-Toal
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Weidmann
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Weigelt
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Lange
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Kröger
D000293:Adolescent; D000328:Adult; D000368:Aged; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D057176:Compassionate Use Trials; D000080027:Cyclams; D005260:Female; D005858:Germany; 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 / Q000009:adverse effects / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor