title: Successful peripheral blood stem cell mobilization with a cost-efficient single fixed-dose plerixafor schedule in poor mobilizers.
abstract: Plerixafor, although costly, is added to mobilizing chemotherapy and G-CSF to overcome poor stem cell mobilization. We demonstrate that it can be safely administered mostly once as a single dose in preemptive and rescue settings, leading to apheresis yields of >2 and >4×106CD34 + cells/kg body weight (bw) in 83% and 48%, respectively. Of note, 35/46 (76%) patients showed a substantial benefit with increased peripheral blood (PB) CD34 + cells prior to apheresis (8.84 vs. 1.72/μl, p < .001), and 5-fold increased CD34 + cells collected per single apheresis (2.25 vs. 0.43 × 106CD34+/kg bw, respectively, p < .001). Patients profiting most (76%) vs. less (24%) had >5 vs. <5/μl PB CD34 + cells before plerixafor application, respectively, thus careful patient selection in the latter group is advised. To the best of our knowledge, this is the first report demonstrating that favorable apheresis results can be obtained using this cost-efficient, single fixed-dose plerixafor schedule.
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Greil
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Chrissoula
authors.initials: C
authors.lastname: Kiote-Schmidt
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Geertje
authors.initials: G
authors.lastname: Fink
authors.affiliation: b Clinical Trials Unit , Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ihorst
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Steffi
authors.initials: S
authors.lastname: Hildenbeutel
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Bosse
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Justus
authors.initials: J
authors.lastname: Duyster
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Engelhardt
authors.affiliation: a Department of Hematology , Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg , Freiburg , Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Wäsch
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001596:Benzylamines; D001781:Blood Component Removal; D002452:Cell Count; D002469:Cell Separation / Q000379:methods; D000080027:Cyclams; D004334:Drug Administration Schedule; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects / Q000379:methods; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D000072916:Peripheral Blood Stem Cells / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor
keywords: CD34; Poor mobilizer; apheresis; plerixafor; stem cells