title: Optimizing mobilization strategies in difficult-to-mobilize patients: The role of plerixafor.
abstract: Peripheral blood stem cell collection is currently the most widely used source for hematopoietic autologous transplantation. Several factors such as advanced age, previous chemotherapy, disease and marrow infiltration at the time of mobilization influence the efficacy of CD34(+) progenitor cell mobilization. Despite the safety and efficiency of the standard mobilization protocols (G-CSF ± chemotherapy), there is still a significant amount of mobilization failure rate (10-40%), which necessitate novel agents for effective mobilization. Plerixafor, is a novel agent, has been recently approved for mobilization of hematopoietic stem cells (HSCs). The combination of Plerixafor with G-CSF provides the collection of large numbers of stem cells in fewer apheresis sessions and can salvage those who fail with standard mobilization regimens. The development and optimization of practical algorithms for the use Plerixafor is crucial to make hematopoietic stem cell mobilization more efficient in a cost-effective way. This review is aimed at summarizing how to identify poor mobilizers, and define rational use of Plerixafor for planning mobilization in hard-to-mobilize patients.
authors.affiliation: Hematology Department, Hacettepe University School of Medicine, Ankara, Turkey. Electronic address: hgoker1@yahoo.com.
authors.forename: Hakan
authors.initials: H
authors.lastname: Goker
authors.affiliation: Hematology Department, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Sezgin
authors.initials: S
authors.lastname: Etgul
authors.affiliation: Hematology Department, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Buyukasik
mesh_terms: D001596:Benzylamines; D000080027:Cyclams; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans
chemical_list: D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor
keywords: Hard-to-mobilize patients; Plerixafor; Stem cell mobilization