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Plerixafor added to chemotherapy plus G-CSF is safe and allows adequate PBSC collection in predicted poor mobilizer patients with multiple myeloma or lymphoma.
- Source :
-
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2012 Feb; Vol. 18 (2), pp. 241-9. Date of Electronic Publication: 2011 Jul 24. - Publication Year :
- 2012
-
Abstract
- We evaluated the safety and efficacy of plerixafor, subsequent to disease-specific chemotherapy followed by granulocyte-colony stimulating factor (G-CSF), in 37 multiple myeloma (MM) or lymphoma patients, who were candidates for autologous stem cell transplantation (ASCT) predicted as poor mobilizers (PMs). Patients were identified as predicted PMs according to the history of a previously failed mobilization attempt or the presence of ≥1 factors predicting an unsuccessful harvest, such as advanced disease, prior extensive radiotherapy, or prolonged treatment, with stem cell poisons, advanced age, or extensive bone marrow involvement. Plerixafor (0.24 mg/kg) was administered subcutaneously for up to 3 consecutive days while continuing G-CSF for 9 to 11 hours before the planned apheresis. Plerixafor administration was safe and no significant adverse events were recorded. We observed a median 4-fold increase (range: 1.4-32) in the number of circulating CD34(+) cells following plerixafor compared with baseline CD34(+) cell concentration (from a median of 5 cells/μL, range: 1-32, to a median of 32 cells/μL, range: 6-201). Twenty-seven of the 37 patients (14 of 17 with MM and 13 of 20 with lymphoma) had ≥2×10(6) CD34(+) cells/kg collected in 1-3 apheretic procedures. Of the 27 patients rescued with plerixafor, 24 (13 MM, 11 lymphoma) have been transplanted with plerixafor-mobilized peripheral blood stem cells, showing a rapid and durable hematologic recovery. Our results suggest that the addition of plerixafor to G-CSF after disease-oriented chemotherapy is safe and allows for a satisfactory harvest in order to perform a safe ASCT, in a relevant proportion of lymphoma and MM patients considered to be PMs.<br /> (Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Anti-HIV Agents adverse effects
Antigens, CD34 blood
Benzylamines
Cyclams
Female
Granulocyte Colony-Stimulating Factor adverse effects
Heterocyclic Compounds adverse effects
Humans
Lymphoma blood
Male
Middle Aged
Multiple Myeloma blood
Recovery of Function
Transplantation, Autologous
Anti-HIV Agents administration & dosage
Granulocyte Colony-Stimulating Factor administration & dosage
Hematopoietic Stem Cell Mobilization
Hematopoietic Stem Cells
Heterocyclic Compounds administration & dosage
Lymphoma therapy
Multiple Myeloma therapy
Peripheral Blood Stem Cell Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6536
- Volume :
- 18
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 21791194
- Full Text :
- https://doi.org/10.1016/j.bbmt.2011.07.014