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Successful “on‐demand” plerixafor for autologous peripheral blood stem‐cells transplantation for relapsed/refractory germ cell tumors
Author(s) -
Corbingi Andrea,
Metafuni Elisabetta,
Di Salvatore Mariantonietta,
Putzulu Rossana,
Chiusolo Patrizia,
Schinzari Giovanni,
Massini Giuseppina,
Rossi Ernesto,
Zini Gina,
Cassano Alessandra,
Sica Simona,
Piccirillo Nicola
Publication year - 2022
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21952
Subject(s) - plerixafor , medicine , apheresis , autologous stem cell transplantation , stem cell , cd34 , chemotherapy , transplantation , multiple myeloma , surgery , oncology , cxcr4 , platelet , chemokine , receptor , biology , genetics
Background Germ cell tumors represent, among solid cancers, a potentially curable disease even if up to 20% to 30% of patients (pts) relapse after first‐line treatment especially considering intermediate and poor prognosis groups. In this scenario, patients are candidates for high‐dose chemotherapy and autologous stem‐cells transplantation as second‐line treatment even though stem‐cells mobilization potential can be affected by several cycles and regimens of chemotherapy. To date, plerixafor is authorized in poor mobilizer adult pts diagnosed with lymphoma or multiple myeloma and in pediatric solid tumors or lymphoma. Therefore, the use of plerixafor in adult pts with relapsing/refractory GCT is still off label. Materials and methods In our study, we describe mobilization and collection of peripheral blood stem cells for 10 pts with germ cell tumors. Six patients underwent plerixafor administration since classified as poor mobilizers based on WBC count (>5.000/μL) and CD34+ cell count (<15/μL) the day before apheresis procedure. Results On the first day of apheresis, plerixafor administration in poor mobilizers made possible a remarkable boost of CD34+ cells in such a way to overlap that of good mobilizers' (32/μL vs 35/μL, respectively, P > .05). Conclusion Therefore, in our experience, plerixafor made a good fraction of poor mobilizer patients eligible for mobilization and collection and able to undergo the predicted autologous stem‐cells transplantation; thus, the lack of access to the use of plerixafor in this setting of patients risks jeopardizing an effective treatment, especially in case of poor prognosis.