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. 2019 Aug;18(2):1141-1148.
doi: 10.3892/etm.2019.7691. Epub 2019 Jun 19.

Efficacy and safety of plerixafor for hematopoietic stem cell mobilization for autologous transplantation in patients with non-Hodgkin lymphoma and multiple myeloma: A systematic review and meta-analysis

Xiaoyang Yang  1 , Mengjie Wan  1 , Feng Yu  1 , Zhidong Wang  2
Affiliations

Efficacy and safety of plerixafor for hematopoietic stem cell mobilization for autologous transplantation in patients with non-Hodgkin lymphoma and multiple myeloma: A systematic review and meta-analysis

Xiaoyang Yang et al. Exp Ther Med. 2019 Aug.

Abstract

Plerixafor in combination granulocyte-colony stimulating factor (G-CSF) has been used for the mobilization of hematopoietic stem cells (HSCs) to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). The aim of this study was to systematically search the published literature and analyze evidence on the efficacy of additional plerixafor for successful HSC mobilization in patients with NHL and MM, and to evaluate the safety of the drug. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google scholar databases were searched electronically for studies published in the English language up to March, 2019. Five studies (3 on NHL and 2 on MM) were included in this review article. The meta-analysis of data of 364 patients in the treatment group and 368 patients in the control group, indicated that the mobilization of ≥5/6×106 CD34+ cells/kg in 4 or less apheresis days was superior with plerixafor + G-CSF than with G-CSF alone (RR=2.59, 95% CI: 1.40 to 4.81; P<0.0001). Similarly, a greater proportion of patients in the treatment group exhibited the mobilization of ≥2×106 CD34+ cells/kg in 4 or less apheresis days (RR=1.46, 95% CI: 1.01 to 2.12; P=0.04). The addition of plerixafor significantly increased the total collection of CD34+ cells (random: MD=4.21; 95% CI: 2.85 to 5.57; P<0.00001). Meta-analysis indicated no significant increase in adverse events with the addition of plerixafor for HSC mobilization (RR=1.03, 95% CI: 0.99 to 1.06; P=0.16). On the whole, the findings of this study indicate that the addition of plerixafor to G-CSF leads to an increased HSC collection in a shorter period of time with no concomitant increase in adverse events. Further randomized controlled trials with a larger sample size evaluating short term efficacy, as well as long term survival would help to further strengthen the evidence on this subject.

Keywords: hematopoietic stem cell; lymphoma; multiple myeloma; plerixafor.

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Figures

Figure 1.
Figure 1.
Flow chart of this study.
Figure 2.
Figure 2.
Forrest plot of non-Hodgkin lymphoma and multiple myeloma for the mobilization of optimal hematopoietic stem cells in 4 or less apheresis days.
Figure 3.
Figure 3.
Forrest plot of non-Hodgkin lymphoma and multiple myeloma for the mobilization of minimal hematopoietic stem cells in 4 or less apheresis days.
Figure 4.
Figure 4.
Forrest plot of mean total number of CD34+ cells collected in up to 4 apheresis days.
Figure 5.
Figure 5.
Forrest plot of the number of patients undergoing transplantation.
Figure 6.
Figure 6.
Forrest plot of adverse events.
Figure 7.
Figure 7.
Risk of bias summary.
See this image and copyright information in PMC

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