Blood graft lymphocyte subsets after plerixafor injection in non-Hodgkin's lymphoma patients mobilizing poorly with chemotherapy plus granulocyte-colony-stimulating factor.
BACKGROUND
A combination of chemotherapy plus granulocyte-colony-stimulating factor (G-CSF) (chemomobilization) is commonly used to mobilize CD34+ cells to circulation. Plerixafor, a chemokine CXCR4 antagonist, increases the mobilization of CD34+ cells and may also have effect on graft composition.


METHODS
We have analyzed lymphocyte subsets in grafts collected on the next morning after plerixafor injection in 13 chemomobilized patients with non-Hodgkin's lymphoma (NHL) mobilizing poorly. As controls we had the first leukapheresis products from 11 NHL patients mobilized with chemotherapy plus G-CSF. The analyses were performed from cryopreserved apheresis products.


RESULTS
The median counts of both total CD3+ T cells and natural killer (NK) cells (CD3-CD16/56+) in the graft were significantly higher in plerixafor-treated group compared to the control group. Both helper T-lymphocytes (CD3+CD4+) and suppressor T-lymphocytes (CD3+CD8+) were significantly increased in the plerixafor-treated group so that CD4+/CD8+ ratio in the graft did not differ between the groups. CD19+ cells were evident only at very small amounts in few patients in both groups, and the CD34+ cell content of the graft did not differ between the groups. Engraftment after high-dose therapy was comparable between the groups.


CONCLUSIONS
Plerixafor added to chemomobilization in poor mobilizers seems to mobilize more T cells and NK cells than chemomobilization. Larger patient numbers and longer follow-up is needed in regard to evaluate posttransplant complications and risk of relapse in patients receiving plerixafor due to poor mobilization.
Department of Medicine, Kuopio University Hospital, Kuopio, Finland. ville.varmavuo@kuh.fi
Ville
V
Varmavuo
Pentti
P
Mäntymaa
Taru
T
Kuittinen
Tapio
T
Nousiainen
Esa
E
Jantunen
D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D003131:Combined Modality Therapy; D000080027:Cyclams; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000378:metabolism; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D007958:Leukocyte Count; D016131:Lymphocyte Subsets / Q000166:cytology*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D019718:Receptors, CXCR4 / Q000037:antagonists & inhibitors; D012189:Retrospective Studies; D000069283:Rituximab; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
D058846:Antibodies, Monoclonal, Murine-Derived; D018952:Antigens, CD34; D001596:Benzylamines; C527276:CXCR4 protein, human; D000080027:Cyclams; D006571:Heterocyclic Compounds; C571759:R-CHOP protocol; D019718:Receptors, CXCR4; D016179:Granulocyte Colony-Stimulating Factor; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; C088327:plerixafor; D011241:Prednisone