Plerixafor to the rescue: boosting peripheral blood stem cell mobilization in patients previously treated with hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone/methotrexate, cytarabine (Hyper-CVAD) chemotherapy. Issue 7 (July 2014)

• Record Type: Journal Article
• Authors: Yuan, Shan; Wang, Shirong; Salhotra, Amandeep; Nademanee, Auayporn
• Is Part Of: Leukemia & lymphoma. Volume 55:Issue 7(2014:Jul.)
• Page Start: 1557
• Page End: 1562
• Publication Date: 2014-07
• Subjects: Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2013.847937
• Languages: English
• ISSNs: 1042-8194

Abstract

<abstract> <title>Abstract</title> <p>Hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone/methotrexate, cytarabine (Hyper-CVAD) chemotherapy exerts deleterious effects on peripheral blood stem cell (PBSC) mobilization. We retrospectively reviewed the use of plerixafor to salvage mobilization in 18 Hyper-CVAD treated patients who initially mobilized poorly with chemotherapy and granulocyte colony stimulating factor (G-CSF). After plerixafor administration the median peripheral blood (PB) CD34 + count rose from 3.74/μL (0–17/μL) to 6.85/μL (0–47.2/μL). The patients collected a median of 1.64 (0.21–5.56) × 10⁶ CD34 + cells/kg with a median number of 3 (1–4) doses in the same collection cycle, and 11 patients reached the 2.0 × 10⁶ CD34 + cells/kg minimum required for transplant. Six patients were remobilized later with G-CSF and plerixafor, and three additional patients reached this goal. For these 14 patients the median number of doses of plerixafor required to reach 2.0 × 10⁶ CD34 + cells/kg was 3 (range 1–4). In conclusion, plerixafor can be utilized successfully in many cases to overcome the effects of Hyper-CVAD on PBSC mobilization.</p> </abstract>