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Plerixafor and granulocyte–colony‐stimulating factor (G‐CSF) in patients with lymphoma and multiple myeloma previously failing mobilization with G‐CSF with or without chemotherapy for autologous hematopoietic stem cell mobilization: the Austrian experience on a named patient program
Author(s) -
Worel Nina,
Rosskopf Konrad,
Neumeister Peter,
Kasparu Hedwig,
Nachbaur David,
Russ Gudrun,
Namberger Konrad,
Witt Volker,
Schloegl Ernst,
Zojer Niklas,
Linkesch Werner,
Kalhs Peter,
Greinix Hildegard T.
Publication year - 2011
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2010.02896.x
Subject(s) - plerixafor , medicine , granulocyte colony stimulating factor , multiple myeloma , mobilization , cd34 , autologous stem cell transplantation , chemotherapy , lymphoma , surgery , stem cell , haematopoiesis , gastroenterology , oncology , cxcr4 , biology , genetics , chemokine , receptor , archaeology , history
BACKGROUND: Plerixafor in combination with granulocyte–colony‐stimulating factor (G‐CSF) has been shown to enhance stem cell mobilization in patients with multiple myeloma, non‐Hodgkin's lymphoma, and Hodgkin's disease who demonstrated with previous mobilization failure. In this named patient program we report the Austrian experience in insufficiently mobilizing patients. STUDY DESIGN AND METHODS: Twenty‐seven patients from eight Austrian centers with a median (range) age of 58 (19‐70) years (18 female, nine male) were included in the study. Plerixafor was limited to patients with previous stem cell mobilization failure and was given in the evening of Day 4 of G‐CSF application. RESULTS: A median increase of circulating CD34+ cells within 10 to 11 hours from administration of plerixafor by a factor of 4.7 over baseline was noted. Overall, 20 (74%) patients reached more than 10 × 10 6 CD34+ cells/L in the peripheral blood, resulting in 17 (63%) patients collecting at least 2 × 10 6 CD34+ cells/kg body weight (b.w.; median, 2.6 × 10 6 CD34+ cells/kg b.w.; range, 0.08 × 10 6 ‐8.07 × 10 6 ). Adverse events of plerixafor were mild to moderate and consisted of gastrointestinal side effects and local reactions at the injection site. Thirteen (48%) patients underwent autologous transplantation receiving a median of 2.93 × 10 6 CD34+ cells/kg (range, 1.46 × 10 6 ‐5.6 × 10 6 ) and showed a trilinear engraftment with a median neutrophil recovery on Day 12 and a platelet recovery on Day 14. CONCLUSION: Our study confirms previous investigations showing that plerixafor in combination with G‐CSF is an effective and well‐tolerated mobilization regimen with the potential of successful stem cell collection in patients with previous mobilization failure.