Background Plerixafor is an immunostimulant used in combination with granulocyte–colony stimulating factor (G-CSF) to mobilise peripheral blood for collection and subsequent autologous transplantation in patients with lymphoma or multiple myeloma. Peripheral blood stem cell mobilisation, which is important as a source of haematopoietic stem cells for transplantation, is generally performed using G-CSF alone but is ineffective in about 15–20% of patients. Combining G-CSF with plerixafor increases the number of people who respond to the therapy and produce enough stem cells for transplantation.

Purpose To describe the use and effectiveness of plerixafor for haematopoietic stem cell transplantation recipients.

Material and methods A retrospective observational study was conducted including patients who received plerixafor between May 2011 and August 2016. The variables collected were: sex, age, diagnosis, G-CSF dose received, plerixafor dose received and CD34+ cells/kg collected. The optimal dose of CD34+ cells collected is ≥5x10⁶ cells CD34+/kg, the minimum dose is ≥2x10⁶ cells CD34+/kg and an insufficient dose is ≤2x10⁶ cells CD34+/kg. The end point was the percentage of patients who collected at least 2x10⁶ CD34+ cells/kg.

Results Plerixafor was prescribed in 14 patients, 6 women and 8 men, with an average age of 44 years. A total of 11 patients were diagnosed with lymphoma and three patients with myeloma. All had been treated previously with G-CSF alone without response. The plerixafor dose given was 0.24 mg/kg. and all had previously received G-CSF 10 µg/kg daily for 4 days prior to the first dose of plerixafor. 5 patients required 2 doses of plerixafor. This increased the cost of treatment. 2 (14%) of 14 patients had an optimal mobilisation response to treatment and ≥5x10⁶ cells CD34+/kg were collected. 10 patients (72%) had a minimum mobilisation response (≥2x10⁶ cells CD34+/kg). 2 patients (14%) had a suboptimal mobilisation response to treatment (≤2x10⁶ cells CD34+/kg). Adverse effects were not observed.

Conclusion In general, plerixafor is an effective drug for haematopoietic progenitor cell mobilisation for autologous transplantation; in 72% of patients, at least 2×10⁶ CD34+ cells/kg were collected.

References and/or acknowledgements Mozobil:

EPAR-Summary for the public. EMA.

No conflict of interest