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Clinical Trial
. 2012 Aug;47(8):1051-5.
doi: 10.1038/bmt.2011.217. Epub 2011 Nov 14.

Preemptive dosing of plerixafor given to poor stem cell mobilizers on day 5 of G-CSF administration

M E Horwitz  1 , J P Chute, C Gasparetto, G D Long, C McDonald, A Morris, D A Rizzieri, K M Sullivan, N J Chao
Affiliations
Clinical Trial

Preemptive dosing of plerixafor given to poor stem cell mobilizers on day 5 of G-CSF administration

M E Horwitz et al. Bone Marrow Transplant. 2012 Aug.

Abstract

Plerixafor, given on day 4 of G-CSF treatment is more effective than G-CSF alone in mobilizing hematopoietic progenitor cells. We tested a strategy of preemptive plerixafor use following assessment of the peak mobilization response to 5 days of G-CSF. Patients were eligible for plerixafor if, on day 5 of G-CSF, there were <7 circulating CD34+ cells/μL or if <1.3 × 10(6) CD34+ cells/kg were collected on the first day of apheresis. Plerixafor (0.24 mg/kg s.c.) was given on day 5 of G-CSF followed by apheresis on day 6. This was repeated for up to two additional doses of plerixafor. The primary end point of the study was the percentage of patients who collected at least 2 × 10(6) CD34+ cells/kg. Twenty candidates for auto-SCT enrolled on the trial. The circulating CD34+ cell level increased a median of 3.1 fold (range 1-8 fold) after the first dose of plerixafor and a median of 1.2 fold (range 0.3-6.5 fold) after the second dose of plerixafor. In all, 15 out of 20 (75%) patients achieved the primary end point. In conclusion, the decision to administer plerixafor can be delayed until after the peak mobilization response to G-CSF has been fully assessed.

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Conflict of interest statement

Conflict of Interest

N.C. and M.H. have relevant financial relationships as follows; Genzyme, Research Funding (N.C), and Genzyme, Honoraria and Research Funding (M.H.). Other authors have no relevant financial relationship to disclose.

Figures

Figure 1
Figure 1
Protocol Schema
Figure 2
Figure 2
Mobilization response and total CD34+ cells/kg yield following preemptive dosing of plerixafor given on day 5, 6 and 7 of G-CSF treatment. * indicates patient who did not undergo apheresis due to lack of venous access.
See this image and copyright information in PMC

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