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- Title
The addition of plerixafor is safe and allows adequate PBSC collection in multiple myeloma and lymphoma patients poor mobilizers after chemotherapy and G-CSF.
- Authors
D'Addio, A.; Curti, A.; Worel, N.; Douglas, K.; Motta, M. R.; Rizzi, S.; Dan, E.; Taioli, S.; Giudice, V.; Agis, H.; Kopetzky, G.; Soutar, R.; Casadei, B.; Baccarani, M.; Lemoli, R. M.
- 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.
- Subjects
HEMAPHERESIS; DRUG administration; MULTIPLE myeloma; LYMPHOMAS; STEM cell transplantation; DRUG therapy; LEUKAPHERESIS; PATIENTS
- Publication
Bone Marrow Transplantation, 2011, Vol 46, Issue 3, p356
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2010.128