The effective use of plerixafor as a real-time rescue strategy for patients poorly mobilizing autologous CD34(+)  cells.
Plerixafor enhances CD34(+)  cell mobilization, however, its optimal use is unknown. We hypothesized that plerixafor could "rescue" patients in the midst of mobilization when factors indicated a poor CD34(+)  yield. Of 295 consecutive autologous peripheral blood mobilization attempts at our center, 39 (13%) used plerixafor as rescue strategy due to a CD34(+)  cell concentration <10/μl (median 5.95/μl, n = 30), low CD34(+)  cell yield from prior apheresis day (median 1.06 × 10(6)  CD34(+)  cells/kg, n = 7), or other (n = 2). Patients received a median of one plerixafor dose (range: 1-4). Thirty-four (87%) collected =2 × 10 (6)  CD34(+)  cells/kg and 26 (67%) collected =4 × 10 (6)  CD34(+)  cells/kg. Median collections for lymphoma (n = 24) and myeloma (n = 15) patients were 4.1 × 10(6)  and 8.3 × 10(6)  CD34/kg, respectively. A single dose of plerixafor was associated with an increase in the mean peripheral blood CD34(+)  concentration of 17.2 cells/μl (P < 0.001) and mean increased CD34(+)  cell yield following a single apheresis of 5.11 × 10(6) /kg (P < 0.03). A real-time rescue use of plerixafor is feasible and may allow targeted use of this agent. J. Clin. Apheresis, 2012. © 2012 Wiley Periodicals, Inc.
Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington 98195, USA. agopal@u.washington.edu
Ajay K
AK
Gopal
Mehdi
M
Karami
JoAl
J
Mayor
Mylene
M
Macebeo
Michael
M
Linenberger
William I
WI
Bensinger
Leona
L
Holmberg
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000096:biosynthesis*; D000970:Antineoplastic Agents / Q000494:pharmacology; D001596:Benzylamines; D001781:Blood Component Removal; D000080027:Cyclams; D003520:Cyclophosphamide / Q000494:pharmacology; D003907:Dexamethasone / Q000494:pharmacology; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000494:pharmacology*; D006801:Humans; D007700:Kinetics; D008223:Lymphoma / Q000097:blood / Q000628:therapy; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy
D018952:Antigens, CD34; D000970:Antineoplastic Agents; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone; D003520:Cyclophosphamide; C088327:plerixafor