title: Plerixafor is safe and efficacious for mobilization of peripheral blood stem cells in pediatric patients.
abstract: Chemotherapy followed by filgrastim is the most common strategy used to mobilize autologous peripheral blood stem cells (PBSCs) for high-dose chemotherapy and autologous stem cell transplantation. Unfortunately, this method does not always lead to adequate PBSC collection in heavily treated patients with relapsed malignancies or if multiple transplants are required. Plerixafor, a hematopoietic stem cell mobilizer that inhibits the CXCR4 chemokine receptor and blocks binding of its cognate ligand, stromal cell-derived factor-1α (SDF-1α), has been shown to be safe and efficacious in the mobilization of autologous PBSC in adults. Despite its use in adults, little evidence exists to support its use in children.
  
  
  
  We report a retrospective review of 16 consecutive pediatric patients receiving plerixafor as part of their mobilization regimen at Cincinnati Children's Hospital Medical Center. All patients but one were given 0.24 mg/kg dose of plerixafor and the median number of plerixafor doses received was two (range, one to four doses). One patient received higher doses of plerixafor.
  
  
  
  An adequate number of CD34+ cells were obtained in 14 of 16 patients (87.5%). The median number of CD34+ cells collected for patients who reached collection goal was 6 × 10(6) CD34+ cells/kg (range, 1.6 × 10(6) -12.4 × 10(6) /kg). No acute adverse events were noted to be attributable to plerixafor administration.
  
  
  
  Our findings suggest that plerixafor use in children is safe and efficacious for the mobilization of autologous PBSCs in subjects with relapsed malignancies or requiring stem cells for multiple transplants.
authors.affiliation: Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Ashley
authors.initials: A
authors.lastname: Teusink
authors.affiliation: Hoxworth Blood Center, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Susan
authors.initials: S
authors.lastname: Pinkard
authors.affiliation: Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Stella
authors.initials: S
authors.lastname: Davies
authors.affiliation: Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Mark
authors.initials: M
authors.lastname: Mueller
authors.affiliation: Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Sonata
authors.initials: S
authors.lastname: Jodele
mesh_terms: D000293:Adolescent; D018952:Antigens, CD34 / Q000032:analysis; D001596:Benzylamines; D002648:Child; D002675:Child, Preschool; D000080027:Cyclams; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006571:Heterocyclic Compounds / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D000072916:Peripheral Blood Stem Cells / Q000187:drug effects; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor