Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Hematopoietic Cell Collection

A plerixafor-based strategy allows adequate hematopoietic stem cell collection in poor mobilizers: results from the Canadian Special Access Program

Bone Marrow Transplantation volume 49, pages 751–755 (2014)Cite this article

Subjects

Abstract

Plerixafor effectively mobilizes hematopoietic stem cells (HSCs). However, most patients' cells are successfully collected using traditional strategies and there is limited cost-effectiveness data. The objectives of this study were to: (1) summarize the published reports of mobilization using a plerixafor-based strategy during compassionate access programs and (2) describe the Canadian experience with plerixafor during its availability by Health Canada’s Special Access Program. A literature search identified reports of plerixafor-based mobilization during compassionate access programs. Overall, successful collection of at least 2 × 106 CD34+ cells/kg was achieved in ~75% of patients, and about two-thirds of patients went on to HSCT. A greater proportion of patients had successful collections when plerixafor was used in the upfront or preemptive settings. Plerixafor was made available by Health Canada’s SAP from September 2008 to December 2010. In 96 of 132 (73%) patients, there was successful collection of at least 2 × 106 CD34+ cells/kg. Ninety-nine (75%) patients went on to receive an autologous transplant. Plerixafor-based mobilization is effective in perceived poor mobilizers. The optimal way to incorporate plerixafor into a mobilization strategy, however, remains to be determined. Centre-specific analysis of resource utilization may help to identify the most cost-effective way to implement various plerixafor-based mobilization strategies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Attal M, Harousseau J-L, Stoppa A-M, Sotto J-J, Fuzibet J-G, Rossi J-F et al A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. New Engl J Med 1996; 335: 91–97.

    Article  CAS  Google Scholar 

  2. Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K et al High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. New Engl J Med 2003; 348: 1875–1883.

    Article  CAS  Google Scholar 

  3. Philip T, Guglielmi C, Hagenbeek A, Somers R, Van Der Lelie H, Bron D et al Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. New Engl J Med 1995; 333: 1540–1545.

    Article  CAS  Google Scholar 

  4. Schmitz N, Pfistner B, Sextro M, Sieber M, Carella AM, Haenel M et al Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: a randomised trial. Lancet 2002; 359: 2065–2071.

    Article  CAS  Google Scholar 

  5. Akhtar SWA, Rahal M, Khafaga Y, Tbakhi A, Humaidan H, Maghfoor I . Factors affecting autologous peripheral blood stem cell collection in patients with relapsed or refractory diffuse large cell lymphoma and Hodgkin lymphoma: a single institution result of 168 patients. Leuk Lymphoma 2008; 49: 769–778.

    Article  CAS  Google Scholar 

  6. Demirer TBC, Gooley T, Appelbaum FR, Rowley S, Chauncey T, Lilleby K et al. Factors influencing collection of peripheral blood stem cells in patients with multiple myeloma. Bone Marrow Transplant 1996; 16: 937–941.

    Google Scholar 

  7. Kuittinen TNT, Halonen P, Mahlamäki E, Jantunen E . Prediction of mobilisation failure in patients with non-Hodgkin's lymphoma. Bone Marrow Transplant 2004; 33: 907–912.

    Article  CAS  Google Scholar 

  8. Pavone V GF, Console G, Vitolo U, Iacopino P, Guarini A, Liso V et al. Poor mobilization is an independent prognostic factor in patients with malignant lymphomas treated by peripheral blood stem cell transplantation. Bone Marrow Transplant 2006; 37: 719–724.

    Article  Google Scholar 

  9. Perea GSA, Martino R, Altés A, Martínez C, Cabezudo E, Amill B et al. Predictive factors for a successful mobilization of peripheral blood CD34+ cells in multiple myeloma. Ann Hematol 2001; 80: 591–597.

    Google Scholar 

  10. Fietz T, Rieger K, Dimeo F, Blau IW, Thiel E, Knauf WU . Stem cell mobilization in multiple myeloma patients: do we need an age-adjusted regimen for the elderly? J Clin Apher 2004; 19: 202–207.

    Article  CAS  Google Scholar 

  11. Bensinger W, Appelbaum F, Rowley S, Storb R, Sanders J, Lilleby K et al Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol 1995; 13: 2547–2555.

    Article  CAS  Google Scholar 

  12. Kumar S, Dispenzieri A, Lacy MQ, Hayman SR, Buadi FK, Gastineau DA et al Impact of lenalidomide therapy on stem cell mobilization and engraftment post-peripheral blood stem cell transplantation in patients with newly diagnosed myeloma. Leukemia 2007; 21: 2035–2042.

    Article  CAS  Google Scholar 

  13. Laszlo DGP, Raspadori D, Tozzi M, Lauria F, Martinelli G . Fludarabine combination regimen severely affected peripheral blood stem cell mobilization. Acta Haematol 2004; 111: 228–229.

    Article  Google Scholar 

  14. Pusic I, Jiang SY, Landua S, Uy GL, Rettig MP, Cashen AF et al Impact of mobilization and remobilization strategies on achieving sufficient stem cell yields for autologous transplantation. Biol Blood Marrow Transplant 2008; 14: 1045–1056.

    Article  CAS  Google Scholar 

  15. Broxmeyer HEOC, Clapp DW, Hangoc G, Cooper S, Plett PA, Liles WC et al. Rapid mobilization of murine and human hematopoietic stem and progenitor cells with AMD3100, a CXCR4 antagonist. J Exp Med 2005; 201: 1307–1318.

    Article  CAS  Google Scholar 

  16. Rosenkilde MMGL, Hatse S, Skerlj RT, Schols D, Bridger GJ, Schwartz TW . Molecular mechanism of action of monocyclam versus bicyclam non-peptide antagonists in the CXCR4 chemokine receptor. J Biol Chem 2007; 282: 27354–27365.

    Article  CAS  Google Scholar 

  17. Flomenberg N, Devine SM, DiPersio JF, Liesveld JL, McCarty JM, Rowley SD et al The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone. Blood 2005; 106: 1867–1874.

    Article  CAS  Google Scholar 

  18. Liles WC, Rodger E, Broxmeyer HE, Dehner C, Badel K, Calandra G et al Augmented mobilization and collection of CD34+ hematopoietic cells from normal human volunteers stimulated with granulocyte–colony-stimulating factor by single-dose administration of AMD3100, a CXCR4 antagonist. Transfusion 2005; 45: 295–300.

    Article  CAS  Google Scholar 

  19. DiPersio JF, Stadtmauer EA, Nademanee A, Micallef INM, Stiff PJ, Kaufman JL et al Plerixafor and G-CSF versus placebo and G-CSF to mobilize hematopoietic stem cells for autologous stem cell transplantation in patients with multiple myeloma. Blood 2009; 113: 5720–5726.

    CAS  Google Scholar 

  20. DiPersio JF, Micallef IN, Stiff PJ, Bolwell BJ, Maziarz RT, Jacobsen E et al Phase III Prospective Randomized Double-Blind Placebo-Controlled Trial of plerixafor plus granulocyte colony-stimulating factor compared with placebo plus granulocyte colony-stimulating factor for autologous stem-cell mobilization and transplantation for patients with non-Hodgkin's lymphoma. J Clin Oncol 2009; 27: 4767–4773.

    Article  CAS  Google Scholar 

  21. Gertz MA . Current status of stem cell mobilization. Br J Haematol 2010; 150: 647–662.

    Article  CAS  Google Scholar 

  22. Tanhehco YC, Vogl DT, Stadtmauer EA, O'Doherty U . The evolving role of plerixafor in hematopoietic progenitor cell mobilization. Transfusion 2013; 53: 2314–2326.

    CAS  PubMed  Google Scholar 

  23. Basak GW, Jaksic O, Koristek Z, Mikala G, Basic-Kinda S, Mayer J et al Haematopoietic stem cell mobilization with plerixafor and G-CSF in patients with multiple myeloma transplanted with autologous stem cells. Eur J Haematol 2011; 86: 488–495.

    Article  CAS  Google Scholar 

  24. Douglas KWPA, Hayden PJ, Rahemtulla A, D'Addio A, Lemoli RM, Rao K et al. Plerixafor for PBSC mobilisation in myeloma patients with advanced renal failure: safety and efficacy data in a series of 21 patients from Europe and the USA. Bone Marrow Transplant 2012; 47: 18–23.

    Article  CAS  Google Scholar 

  25. Arcaini LLD, Rizzi S, Balzarotti M, Antoniazzi F, Zilioli VR, Guggiari E et al. Plerixafor and G-CSF for PBSC mobilization in patients with lymphoma who failed previous attempts with G-CSF and chemotherapy: a REL (Rete Ematologica Lombarda) experience. Leuk Res 2011; 35: 712–714.

    Article  CAS  Google Scholar 

  26. D'Addio ACA, Worel N, Douglas K, Motta MR, Rizzi S, Dan E et al. The addition of plerixafor is safe and allows adequate PBSC collection in multiple myeloma and lymphoma patients poor mobilizers after chemotherapy and G-CSF. Biol Blood Marrow Transplant 2011; 46: 356–363.

    Article  CAS  Google Scholar 

  27. Shaughnessy PUJ, Devine S, Maziarz RT, Vose J, Micallef I, Jacobsen E et al. Plerixafor and G-CSF for autologous stem cell mobilization in patients with NHL, Hodgkin's lymphoma and multiple myeloma: results from the expanded access program. Bone Marrow Transplant 2013; 48: 777–781.

    Article  CAS  Google Scholar 

  28. Hübel KFM, Salwender H, Basara N, Beier R, Theurich S, Christopeit M et al Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program. Bone Marrow Transplantation 2011; 46: 1045–1052.

    Article  Google Scholar 

  29. Hübel KFM, Apperley JF, Basak GW, Douglas KW, Gabriel IH, Geraldes C et al. European data on stem cell mobilization with plerixafor in non-Hodgkin's lymphoma, Hodgkin's lymphoma and multiple myeloma patients. A subgroup analysis of the European Consortium of stem cell mobilization. Bone Marrow Transplant 2012; 47: 1046–1050.

    Article  Google Scholar 

  30. Selleslag D, Dierickx D, Breems DA, Huynh P, Van De Velde A, Meers S et al Plerixafor in poor stem cell mobilizers: the Belgian Compassionate Use Program. Acta Clin Belg 2011; 66: 200–204.

    CAS  PubMed  Google Scholar 

  31. Calandra GMJ, McGuirk J, Tricot G, Crocker SA, Badel K, Grove B et al AMD3100 plus G-CSF can successfully mobilize CD34+ cells from non-Hodgkin's lymphoma, Hodgkin's disease and multiple myeloma patients previously failing mobilization with chemotherapy and/or cytokine treatment: compassionate use data. Bone Marrow Transplant 2008; 41: 331–338.

    Article  CAS  Google Scholar 

  32. Worel N, Rosskopf K, Neumeister P, Kasparu H, Nachbaur D, Russ G et al Plerixafor and granulocyte–colony-stimulating factor (G-CSF) in patients with lymphoma and multiple myeloma previously failing mobilization with G-CSF with or without chemotherapy for autologous hematopoietic stem cell mobilization: the Austrian experience on a named patient program. Transfusion 2011; 51: 968–975.

    Article  CAS  Google Scholar 

  33. Olivieri AMM, Lemoli R, Tarella C, Iacone A, Lanza F, Rambaldi A et al. Proposed definition of 'poor mobilizer' in lymphoma and multiple myeloma: an analytic hierarchy process by ad hoc working group Gruppo ItalianoTrapianto di Midollo Osseo. Bone Marrow Transplant 2011; 47: 342–351.

    Article  Google Scholar 

  34. Li J, Hamilton E, Vaughn L, Graiser M, Renfroe H, Lechowicz MJ et al Effectiveness and cost analysis of ‘just-in-time’ salvage plerixafor administration in autologous transplant patients with poor stem cell mobilization kinetics. Transfusion 2011; 51: 2175–2182.

    Article  Google Scholar 

  35. Vishnu P, Roy V, Paulsen A, Zubair AC . Efficacy and cost-benefit analysis of risk-adaptive use of plerixafor for autologous hematopoietic progenitor cell mobilization. Transfusion 2012; 52: 55–62.

    Article  CAS  Google Scholar 

  36. Abhyankar SDS, Aljitawi O, Ganguly S, Merkel D, McGuirk J . A risk-based approach to optimize autologous hematopoietic stem cell (HSC) collection with the use of plerixafor. Bone Marrow Transplant 2012; 47: 483–487.

    Article  CAS  Google Scholar 

  37. Cooper DL, Pratt K, Baker J, Medoff E, Conkling-Walsh A, Foss F et al Late afternoon dosing of plerixafor for stem cell mobilization: a practical solution. Clin Lymphoma Myeloma Leuk 2011; 11: 267–272.

    Article  CAS  Google Scholar 

  38. Costa LJMA, Alexander ET, Hogan KR, Shabbir M, Schaub C, Stuart RK . Growth factor and patient-adapted use of plerixafor is superior to CY and growth factor for autologous hematopoietic stem cells mobilization. Bone Marrow Transplant 2011; 46: 523–528.

    Article  CAS  Google Scholar 

  39. Shaughnessy PCN, Shapiro J, Walters K, McCarty J, Abhyankar S, Shayani S et al. Pharmacoeconomics of hematopoietic stem cell mobilization: an overview of current evidence and gaps in the literature. Biol Blood Marrow Transplant 2013; 19: 1301–1309.

    Article  Google Scholar 

  40. Attolico IPV, Ostuni A, Rossini B, Musso M, Crescimanno A, Martino M et al. Plerixafor added to chemotherapy plus G-CSF is safe and allows adequate PBSC collection in predicted poor mobilizer patients with multiple myeloma or lymphoma. Biology of blood and marrow transplantation 2012; 18: 241–249.

    Article  CAS  Google Scholar 

  41. Basak G, Knopinska-Posluszny W, Matuszak M, Kisiel E, Hawrylecka D, Szmigielska-Kaplon A et al. Hematopoietic stem cell mobilization with the reversible CXCR4 receptor inhibitor plerixafor (AMD3100)—Polish compassionate use experience. Annals of hematology 2011; 90: 557–568.

    Article  CAS  Google Scholar 

  42. Duarte RFSB, Marín P, Kottaridis P, Ortiz M, Morante C, Delgado J et al. Plerixafor plus granulocyte CSF can mobilize hematopoietic stem cells from multiple myeloma and lymphoma patients failing previousmobilization attempts: EU compassionate use data. Bone Marrow Transplantation 2011; 46: 52–58.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank the CBMTG centres for providing data and Sanofi for providing an unrestricted educational grant. This study was supported by an unrestricted educational grant from Sanofi.

Author information

Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Blood and Marrow Transplant Program, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada

    D Sheppard, C Bredeson, L Huebsch, D Allan & J Tay

Authors
  1. D Sheppard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Bredeson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L Huebsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D Allan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J Tay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Sheppard.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sheppard, D., Bredeson, C., Huebsch, L. et al. A plerixafor-based strategy allows adequate hematopoietic stem cell collection in poor mobilizers: results from the Canadian Special Access Program. Bone Marrow Transplant 49, 751–755 (2014). https://doi.org/10.1038/bmt.2014.33

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2014.33

This article is cited by

Search

Advanced search

Quick links