title: Plerixafor as first- and second-line strategies for autologous stem cell mobilization in patients with non-Hodgkin's lymphoma or multiple myeloma.
abstract: OBJECTIVE
  To describe the institutional experience of plerixafor plus filgrastim as the initial peripheral blood stem cell (PBSC) mobilization (first-line strategy) and as rescue therapy after failure with filgrastim plus cyclophosphamide (second-line strategy).
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Thirty-three patients (median age 62 yrs) who received plerixafor between January 2008 and December 2009.
  
  
  RESULTS
  We collected data on total CD34(+) cell yield and number of apheresis sessions in both first-line and second-line plerixafor recipients. Mobilization with plerixafor plus filgrastim resulted in a median yield of 8.95 × 10(6) and 2.45 × 10(6) CD34(+) cells/kg in patients with multiple myeloma or non-Hodgkin's lymphoma, respectively. As rescue mobilization, plerixafor plus filgrastim successfully mobilized CD34(+) cells in 16 (84%) of 19 patients. When comparing first-line plerixafor plus filgrastim therapy with second-line therapy, we found an increase in CD34(+) yield and 1 less apheresis day in patients with multiple myeloma, but no difference in patients with non-Hodgkin's lymphoma.
  
  
  CONCLUSIONS
  A regimen of plerixafor plus filgrastim successfully mobilized CD34(+) cells in a median of 1 apheresis day for patients with multiple myeloma and 2 apheresis days for patients with non-Hodgkin's lymphoma, including patients who failed initial filgrastim plus cyclophosphamide mobilization. Plerixafor plus filgrastim could be a viable first-line option in patients with multiple myeloma, as it improved CD34(+) cell yield and decreased number of apheresis days compared with second-line plerixafor plus filgrastim therapy, whereas it was comparable to second-line therapy in patients with non-Hodgkin's lymphoma.
authors: Department of Pharmacy, University of California San Diego Medical Center, San Diego, CA 92103-8765, USA. kloricacid@gmail.com
authors: Kevin W
authors: KW
authors: Lor
authors: Pieter J
authors: PJ
authors: Helmons
authors: Helen
authors: H
authors: Belew
authors: James R
authors: JR
authors: Lane
authors: Edward D
authors: ED
authors: Ball
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D000080027:Cyclams; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D000069585:Filgrastim; C088327:plerixafor