title: Temporal changes in plerixafor administration and hematopoietic stem cell mobilization efficacy: results of a prospective clinical trial in multiple myeloma.
abstract: Plerixafor with granulocyte colony-stimulating factor (G-CSF) is effective for hematopoietic stem cell (HSC) mobilization in patients with non-Hodgkin Lymphoma and myeloma; however, labeling requires dosing 11 hours before apheresis. Pharmacodynamic studies show peak blood CD34(+) cell counts at 10 to 14 hours; limited data are available for later time points. To address the effect of afternoon plerixafor dosing on CD34(+) cell yields, we conducted a prospective clinical trial in myeloma patients undergoing stem cell collection. Thirty-one patients received plerixafor 17 hours before apheresis; blood CD34(+) cells were measured before the first plerixafor dose and 1, 3, and 17 ± 1 hours after treatment. The target HSC number (≥10 × 106 CD34(+) cells/kg) was collected from 22 subjects (73%) in 1 day and from all subjects within 3 days. Hematopoietic engraftment after transplantation and adverse events were similar to previous studies. Plerixafor given 17 hours before apheresis yields desired HSC collection efficiencies after induction treatment in myeloma patients.
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA. donald.harvey@emory.edu
authors.forename: R Donald
authors.initials: RD
authors.lastname: Harvey
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Kaufman
authors.forename: Heather R
authors.initials: HR
authors.lastname: Johnson
authors.forename: Ajay
authors.initials: A
authors.lastname: Nooka
authors.forename: Louette
authors.initials: L
authors.lastname: Vaughn
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Flowers
authors.forename: H Jean
authors.initials: HJ
authors.lastname: Khoury
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Lechowicz
authors.forename: Amelia A
authors.initials: AA
authors.lastname: Langston
authors.forename: Sagar
authors.initials: S
authors.lastname: Lonial
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
mesh_terms: D000328:Adult; D000368:Aged; D001596:Benzylamines; D001781:Blood Component Removal / Q000379:methods; D000080027:Cyclams; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: Hematopoietic stem cell mobilization; Multiple myeloma; Pharmacodynamics; Plerixafor; Timing