Premium
Plerixafor is effective given either preemptively or as a rescue strategy in poor stem cell mobilizing patients with multiple myeloma
Author(s) -
Cheng Jian,
Schmitt Michael,
Wuchter Patrick,
Buss Eike C.,
WitzensHarig Mathias,
Neben Kai,
Hundemer Michael,
Hillengass Jens,
Alexi Renate,
Goldschmidt Hartmut,
Chen Baoan,
Ho Anthony D.,
Schmitt Anita
Publication year - 2015
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/trf.12813
Subject(s) - plerixafor , multiple myeloma , medicine , stem cell , mobilization , surgery , pharmacology , cxcr4 , biology , history , chemokine , receptor , archaeology , genetics
Background Harvest of more than one CD 34+ stem cell transplant has become the standard, to ensure the option for a second autologous transplantation in patients with relapsed or progressive multiple myeloma ( MM ). Additional administration of the CXCR ‐4 inhibitor plerixafor has been shown to increase the efficiency of CD 34+ stem cell harvest. However, the algorithm when to apply plerixafor is still under debate. Study Design and Methods I n this retrospective study, 46 MM patients were categorized into four groups according to their CD 34+ stem cell count in peripheral blood ( PB ) and mobilization with or without plerixafor: G roup A comprised poor mobilizers with CD 34+ cell counts of fewer than 20 × 10 6 /L in PB . G roup B included inadequate mobilizers with CD 34+ cell counts of 20 × 10 6 / L or more in PB and a low CD 34+ stem cell yield in the first leukapheresis session. Patients receiving plerixafor preemptively ( G roup A 1) and as a rescue strategy ( G roup B 1) were compared to patients continuing stem cell collection with granulocyte–colony‐stimulating factor alone ( G roups A 2 and B 2). Results In both, the preemptive and the rescue settings, plerixafor enhanced the CD 34+ stem cell yield significantly. Poor mobilization and administration of plerixafor was not associated with delayed engraftment. Conclusion Our data demonstrate that administration of plerixafor is safe and effective and facilitates a significantly higher CD 34+ stem cell harvest. Based on the presented data, we propose an algorithm for the use of plerixafor for CD 34+ stem cell mobilization and harvesting in poor mobilizing myeloma patients.