title: Novel strategies for blood stem cell mobilization: special focus on plerixafor.
abstract: BACKGROUND
  More than 98% of autologous stem cell transplants are now performed with the support of mobilized blood stem cells, and the proportion of allogeneic blood stem cell transplants has risen to more than 70%. Blood stem cell mobilization strategies are therefore important components of all transplant programs.
  
  
  METHODS
  Stem cell mobilization strategies are evaluated based on current literature, with special focus on the use of plerixafor, a CXCR4 chemokine receptor antagonist. Mobilization methods in autologous settings include the use of G-CSF alone or following chemotherapy (chemomobilization), and the use of G-CSF alone in allogeneic transplants. A combination of G-CSF + plerixafor has been shown to be effective in patients who have failed a previous mobilization. This combination has also been found to be superior to G-CSF alone in Phase III studies in myeloma and non-Hodgkin lymphoma patients as the first-line mobilization.
  
  
  CONCLUSIONS
  Addition of plerixafor to chemomobilization or G-CSF mobilization may be more cost-effective than its routine use, and it is worth considering in predicted or proven poor mobilizers. Novel mobilization strategies have allowed more successful stem cell collection in autologous setting, although the effect of plerixafor on graft content and long-term patient outcomes needs further investigation.
authors.affiliation: University of Eastern Finland, and Kuopio University Hospital, Department of Medicine, POB 1777, 70211 Kuopio, Finland. esa.jantunen@kuh.fi
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
mesh_terms: D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001596:Benzylamines; D000080027:Cyclams; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008223:Lymphoma / Q000628:therapy*; D009101:Multiple Myeloma / Q000628:therapy*; D033581:Stem Cell Transplantation
chemical_list: D019380:Anti-HIV Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor