title: Blood graft composition after plerixafor injection in patients with NHL.
abstract: BACKGROUND
  Plerixafor is used to mobilize CD34(+)  hematopoietic stem cells from bone marrow to circulation. Limited data are available in regard to graft cellular content collected after plerixafor.
  
  
  OBJECTIVE
  The aim of this study was to assess effects of plerixafor added to chemomobilization on graft CD34(+)  cell subclasses, lymphocyte subsets, engraftment, and post-transplant course in non-Hodgkin lymphoma (NHL) patients.
  
  
  METHODS
  Thirty-four patients with NHL were included. All patients received chemotherapy plus G-CSF to mobilize stem cells. Nineteen patients received plerixafor pre-emptively owing to poor mobilization or poor collection yields. The rest of the patients constituted the control group. Flow cytometric analyzes were performed from cryopreserved graft samples. Also, data on post-transplant engraftment and outcome were collected.
  
  
  RESULTS
  The proportion of primitive stem cells (CD34(+)  CD133(+)  CD38(-) ) was significantly higher after the plerixafor injection when compared to the first collection in the control group. The amount of T cells (CD3(+) ), helper (CD3(+)  CD4(+) ) T subsets, and suppressor (CD3(+)  CD8(+) ) T subsets in the graft was all significantly higher in the plerixafor group. Also, the amount of NK cells (CD3(-)  CD16/56(+) ) was higher. Engraftment after high-dose therapy was comparable between the groups, but leukocyte and platelet count at 6 months were higher in patients receiving plerixafor-mobilized grafts.
  
  
  CONCLUSIONS
  Plerixafor, when used pre-emptively in addition to chemomobilization, seems to mobilize more primitive CD34(+)  stem cells, T lymphocytes, and NK cells. Whether these differences are associated with immune reconstitution, long-term engraftment, or patient outcomes needs to be evaluated in larger patient groups with longer follow-up.
authors.affiliation: Department of Medicine, Kuopio University Hospital, Finland.
authors.forename: Ville
authors.initials: V
authors.lastname: Varmavuo
authors.forename: Pentti
authors.initials: P
authors.lastname: Mäntymaa
authors.forename: Tapio
authors.initials: T
authors.lastname: Nousiainen
authors.forename: Piia
authors.initials: P
authors.lastname: Valonen
authors.forename: Taru
authors.initials: T
authors.lastname: Kuittinen
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018952:Antigens, CD34; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001596:Benzylamines; D000080027:Cyclams; D005260:Female; D005434:Flow Cytometry; D006085:Graft Survival / Q000187:drug effects; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D013601:T-Lymphocytes / Q000473:pathology; D014182:Transplantation, Autologous
chemical_list: D019380:Anti-HIV Agents; D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor