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Journal of Oncology
Volume 2012, Article ID 931071, 5 pages
http://dx.doi.org/10.1155/2012/931071
Research Article

Plerixafor Salvage Is Safe and Effective in Hard-to-Mobilize Patients Undergoing Chemotherapy and Filgrastim-Based Peripheral Blood Progenitor Cell Mobilization

1Bone Marrow Transplant Program, Section of Hematology/Oncology, Department of Medicine, Georgia Health Sciences University, Augusta, GA 30912, USA
2Department of Pharmacy, Georgia Health Sciences University, Augusta, GA, USA
3Osborn Hematopoietic Malignancy and Transplant Program, West Virginia University, Morgantown, WV 26506, USA

Received 21 December 2011; Accepted 8 February 2012

Academic Editor: Edward A. Copelan

Copyright © 2012 Farrukh T. Awan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The combination of filgrastim (G-CSF) and plerixafor is currently approved for mobilizing peripheral blood progenitor cells in patients with non-Hodgkin lymphoma and multiple myeloma undergoing autologous peripheral blood hematopoietic cell transplantation. However, chemotherapy and G-CSF-based mobilization remains a widely used strategy for peripheral blood progenitor cell collection. In this paper we describe our experience from two North American transplant centers in a series of patients who received salvage plerixafor while failing chemotherapy and G-CSF mobilization. Patients received a median of two doses of plerixafor salvage upon failure to mobilize adequate number of peripheral blood progenitor cells at neutrophil recovery. The use of plerixafor was associated with a 2.4-fold increase in peripheral blood CD34+ cell count and 3.9-fold increase in total CD34+ cell yield. All patients were able to collect ≥ 2 × 1 0 6 CD34+ cells/kg with this approach. These results were more pronounced in patients with a higher CD34+ cell count at the time of the first plerixafor dose. Interestingly, peripheral blood white blood cell count was not shown to correlate with a response to plerixafor. Our results provide safety and efficacy data for the use of plerixafor in patients who are destined to fail chemomobilization.