Increased mobilization and yield of stem cells using plerixafor in combination with granulocyte-colony stimulating factor for the treatment of non-Hodgkin's lymphoma and multiple myeloma

Louis Pelus, Sherif Farag

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Multiple myeloma and non-Hodgkin's lymphoma remain the most common indications for high-dose chemotherapy and autologous peripheral blood stem cell rescue. While a CD34+ cell dose of 1 × 106/kg is considered the minimum required for engraftment, higher CD34+ doses correlate with improved outcome. Numerous studies, however, support targeting a minimum CD34+ cell dose of 2.0 × 106/kg, and an "optimal" dose of 4 to 6 × 106/kg for a single transplant. Unfortunately, up to 40% of patients fail to mobilize an optimal CD34+ cell dose using myeloid growth factors alone. Plerixa for is a novel reversible inhibitor of CXCR4 that signifcantly increases the mobilization and collection of higher numbers of hematopoietic progenitor cells. Two randomized multi-center clinical trials in patients with non-Hodgkin's lymphoma and multiple myeloma have demonstrated that the addition of plerixafor to granulocyte-colony stimulating factor increases the mobilization and yield of CD34+ cells in fewer apheresis days, which results in durable engraftment. This review summarizes the pharmacology and evidence for the clinical efficacy of plerixafor in mobilizing hematopoietic stem and progenitor cells, and discusses potential ways to utilize plerixafor in a cost-effective manner in patients with these diseases.

Original languageEnglish
Pages (from-to)11-22
Number of pages12
JournalStem Cells and Cloning: Advances and Applications
Volume4
Issue number1
DOIs
StatePublished - 2011

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Hematopoietic Stem Cell Mobilization
Granulocyte Colony-Stimulating Factor
Multiple Myeloma
Non-Hodgkin's Lymphoma
Hematopoietic Stem Cells
Blood Component Removal
Therapeutics
Intercellular Signaling Peptides and Proteins
Clinical Trials
Pharmacology
Transplants
Costs and Cost Analysis
Drug Therapy
JM 3100

Keywords

  • Lymphoma
  • Mobilization
  • Myeloma
  • Plerixafor
  • Stem cells

ASJC Scopus subject areas

  • Cell Biology
  • Medicine (miscellaneous)

Cite this

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abstract = "Multiple myeloma and non-Hodgkin's lymphoma remain the most common indications for high-dose chemotherapy and autologous peripheral blood stem cell rescue. While a CD34+ cell dose of 1 × 106/kg is considered the minimum required for engraftment, higher CD34+ doses correlate with improved outcome. Numerous studies, however, support targeting a minimum CD34+ cell dose of 2.0 × 106/kg, and an {"}optimal{"} dose of 4 to 6 × 106/kg for a single transplant. Unfortunately, up to 40{\%} of patients fail to mobilize an optimal CD34+ cell dose using myeloid growth factors alone. Plerixa for is a novel reversible inhibitor of CXCR4 that signifcantly increases the mobilization and collection of higher numbers of hematopoietic progenitor cells. Two randomized multi-center clinical trials in patients with non-Hodgkin's lymphoma and multiple myeloma have demonstrated that the addition of plerixafor to granulocyte-colony stimulating factor increases the mobilization and yield of CD34+ cells in fewer apheresis days, which results in durable engraftment. This review summarizes the pharmacology and evidence for the clinical efficacy of plerixafor in mobilizing hematopoietic stem and progenitor cells, and discusses potential ways to utilize plerixafor in a cost-effective manner in patients with these diseases.",
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