Plerixafor in combination with granulocyte–colony‐stimulating factor after chemotherapy increases mobilization efficiency in patients with lymphoma or myeloma: results of a Phase II clinical trial. Issue 10 (2nd September 2015)

• Record Type: Journal Article
• Authors: Jagirdar, Neera; Harvey, R. Donald; Nooka, Ajay; Flowers, Christopher; Kaufman, Jonathan; Lonial, Sagar; Lechowicz, Mary Jo; Langston, Amelia; Lipscomb, Carol; Gaylor, Cynthia; Waller, Edmund K.
• Is Part Of: Transfusion. Volume 55:Issue 10(2015)
• Page Start: 2351
• Page End: 2357
• Publication Date: 2015-09-02
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.13186
• Languages: English
• ISSNs: 0041-1132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="trf13186-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>We tested whether adding plerixafor to G‐CSF mobilization after chemotherapy would increase the proportion of patients collecting the target number of CD34+ cells/kg in 1 day of apheresis to >75%.</p> </sec> <sec id="trf13186-sec-0002" sec-type="section"> <title>STUDY DESIGN AND METHODS</title> <p>Autologous stem cell transplant–anticipated multiple myeloma or lymphoma patients were eligible. Patients were mobilized with cyclophosphamide (n=17); DCEP (n=1); R‐ICE (n=20); CHOP (n=2); or R‐HCVAD (n=5) and given 5 mg/kg/day GCSF starting on Day 2 and increasing to 10 mg/kg/day on Day 6. Plerixafor 240 mg/kg was injected subcutaneously on the day the neutrophil count was more than 1.5 × 10<sup>9</sup> cells/L with apheresis the folllowing day. G‐CSF, plerixafor, and apheresis continued daily until 5 × 10<sup>6</sup> (lymphoma) or 10 × 10<sup>6</sup> (myeloma) CD34+ cells/kg were collected.</p> </sec> <sec id="trf13186-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Seventeen myeloma and 28 lymphoma patients enrolled, and 76% collected the target number of CD34+ cells in 1 day. Twelve subjects with median CD34+ counts of 142 × 10<sup>6</sup> cells/L began apheresis without plerixafor and collected 20 × 10<sup>6</sup> CD34+ cells/kg in 1 day. The remaining 33 subjects, with median 11.7 × 10<sup>6</sup> CD34+ cells/L and 5.4 × 10<sup>9</sup> WBC/L, received plerixafor. Plerixafor‐treated subjects collected 7.8 × 10<sup>6</sup> CD34+ cells/kg; 22 (67%) collected in 1 day, while 11 (33%) required more than 1 day. Plerixafor was well tolerated, with no serious adverse events.</p> </sec> <sec id="trf13186-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Plerixafor administration after chemotherapy for autologous stem cell mobilization is feasible, well tolerated, and increases the proportion of subjects collected in a single day compared to mobilization with G‐CSF after chemotherapy.</p> </sec> </abstract>