title: Booster of plerixafor can be successfully used in addition to chemotherapy-based regimen to rescue stem cell mobilization failure.
abstract: BACKGROUND
  Autologous stem cell transplantation (autoSCT) is currently considered one of the standard approaches in the treatment of patients suffering from multiple myeloma and recurrent or relapsed lymphomas. Unfortunately, a significant proportion of those patients fail to mobilize minimum CD34+ cell dose to undergo this procedure. Here we present the strategy that allows to rescue the outcome of ongoing unsuccessful chemotherapy based mobilizations.
  
  
  METHODS
  All five patients failed to release satisfactory number of CD34+ cells to peripheral blood after chemotherapy plus G-CSF-based mobilization regimen, despite raise in leukocytosis. In this situation, we decided to administer a booster of plerixafor, a specific CXCR4 receptor inhibitor. We observed rapid 2.6 to 16-fold increase of peripheral blood CD34+ cells number that allowed to start aphereses in all cases. Consequently, all five patients who would not otherwise collect required number of CD34+ cells, collected above 2.0×106 CD34+ cells/kg that allowed for hematopoietic stem cell transplantation.
  
  
  CONCLUSIONS
  We would like to suggest that poor mobilizers could be rescued with the timely addition of plerixafor, thus they can avoid another procedure of stem cell mobilization.
authors.affiliation: Department of Hematology, Oncology and Internal Diseases, The Medical University of Warsaw, Banacha 1A Str., Warsaw, Poland. gbasak@ib.amwaw.edu.pl
authors.forename: Grzegorz Wladyslaw
authors.initials: GW
authors.lastname: Basak
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Urbanowska
authors.forename: Piotr
authors.initials: P
authors.lastname: Boguradzki
authors.forename: Tigran
authors.initials: T
authors.lastname: Torosian
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Halaburda
authors.forename: Wieslaw
authors.initials: W
authors.lastname: Wiktor-Jedrzejczak
mesh_terms: D000328:Adult; D018952:Antigens, CD34; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054367:Receptors, CXCR3 / Q000037:antagonists & inhibitors; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D054367:Receptors, CXCR3; C088327:plerixafor