title: Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients.
abstract: Up to 10% of germ cell tumor patients require salvage high-dose chemotherapy with stem cell support, achieving cure rates in the range of 10-60%. Stem cell mobilization may be difficult in these patients because of multiple lines of treatment known to seriously hamper stem cell recovery. Plerixafor significantly enhances the success of the CD34+ cell harvest, even in cases where prior mobilization attempts have failed. Six germ cell tumor patients provided informed consent and were included in the compassionate use program. All patients were heavily pretreated, with a median of 3.5 prior lines of therapy. All failed prior mobilization with G-CSF in combination with chemotherapy. Five patients yielded a median of 2.6 × 10(6) CD34+ cells per kg body weight in a median of 4 apheresis days when plerixafor was used. Three patients underwent subsequent high-dose chemotherapy with autologous stem cell support. Median time to leukocyte engraftment was 11 days. Median time to platelet engraftment was 12.5 days, both of which are comparable to previous historical data. Accordingly, plerixafor seems to be safe and effective in germ cell tumor patients who have failed prior mobilization therapy. Larger prospective studies are warranted to further assess its use in germ cell cancer.
authors.affiliation: 1] Department of Oncology, Hematology, Stem Cell Transplantation with the section Pneumology, Department of Internal Medicine II, University Cancer Center Hamburg (Hubertus Wald Tumorzentrum), University Medical Center Hamburg-Eppendorf, Hamburg, Germany. sebastian.kobold@hotmail.de
authors.forename: S
authors.initials: S
authors.lastname: Kobold
authors.forename: J
authors.initials: J
authors.lastname: Isernhagen
authors.forename: K
authors.initials: K
authors.lastname: Hübel
authors.forename: N
authors.initials: N
authors.lastname: Kilic
authors.forename: C
authors.initials: C
authors.lastname: Bogner
authors.forename: N
authors.initials: N
authors.lastname: Frickhofen
authors.forename: C
authors.initials: C
authors.lastname: Bokemeyer
authors.forename: W
authors.initials: W
authors.lastname: Fiedler
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001596:Benzylamines; D003131:Combined Modality Therapy; D057176:Compassionate Use Trials; D000080027:Cyclams; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006571:Heterocyclic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D018239:Seminoma / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor