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Stem Cell Procurement

The addition of plerixafor is safe and allows adequate PBSC collection in multiple myeloma and lymphoma patients poor mobilizers after chemotherapy and G-CSF

Bone Marrow Transplantation volume 46, pages 356–363 (2011)Cite this article

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Abstract

We report 13 multiple myeloma (MM) or lymphoma patients who were failing PBSC mobilization after disease-specific chemotherapy and granulocyte-CSF (G-CSF), and received plerixafor to successfully collect PBSCs. Patients were considered poor mobilizers when the concentration of PB CD34+ cells was always lower than 10 cells/μL, during the recovery phase after chemotherapy and/or were predicted to have inadequate PBSC collection to proceed to autologous transplantation. Plerixafor (0.24 mg/kg) was administered subcutaneously for up to three consecutive days, while continuing G-CSF, 10–11 h before the planned leukapheresis. Plerixafor administration was safe and no significant adverse events were recorded. We observed a 4.7 median fold-increase in the number of circulating CD34+ cells after plerixafor as compared with baseline CD34+ cell concentration (from a median of 6.2 (range 1–12) to 21.5 (range 9–88) cells/μL). All patients collected >2 × 106 CD34+ cells/kg in 1–3 leukaphereses. In all, 5/13 patients have already undergone autograft with plerixafor-mobilized PBSCs, showing a rapid and durable hematological recovery. Our results suggest that the pre-emptive addition of plerixafor to G-CSF after chemotherapy is safe and may allow the rescue of lymphoma and MM patients, who need autologous transplantation but are failing PBSC mobilization.

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Acknowledgements

This work was in part supported by Italian Ministry of Health (Progetto Strategico Oncologia, 2006), Regione Emilia-Romagna (Progetti di Ricerca Università-Regione Emilia Romagna, Progetto Medicina Rigenerativa, 2007), Italian Association Against Leukemia, Bologna (BolognAil).

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Authors and Affiliations

  1. Department of Hematology and Oncological Sciences ‘L and A Seràgnoli’, Institute of Hematology, University of Bologna and Stem Cell Research Center, S Orsola-Malpighi Hospital, Bologna, Italy

    A D'Addio, A Curti, M R Motta, S Rizzi, E Dan, S Taioli, B Casadei, M Baccarani & R M Lemoli

  2. Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria

    N Worel

  3. The Beatson West of Scotland Cancer Centre, Glasgow, UK

    K Douglas & R Soutar

  4. Immunohematology Service and Blood Bank S Orsola-Malpighi Hospital, Bologna, Italy

    V Giudice

  5. Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria

    H Agis

  6. Department of Medicine, General Hospital, St Poelten, Austria

    G Kopetzky

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Professor Roberto M Lemoli has received research support and compensation as a member of the scientific advisory board of Genzyme, Italy.

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D'Addio, A., Curti, A., Worel, N. et al. The addition of plerixafor is safe and allows adequate PBSC collection in multiple myeloma and lymphoma patients poor mobilizers after chemotherapy and G-CSF. Bone Marrow Transplant 46, 356–363 (2011). https://doi.org/10.1038/bmt.2010.128

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