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Successful mobilization of PBSCs in a healthy volunteer donor by addition of plerixafor after failure of mobilization with G-CSF alone

Bone Marrow Transplantation volume 46, pages 762–763 (2011)Cite this article

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Leotta et al.1 recently reported rapid stem cell mobilization with plerixafor after failure of marrow harvest. We report a case of a 50-year-old woman, who was chosen as a sibling donor for PBSCs in an allogeneic transplantation. Standard evaluation procedure before stem cell mobilization showed no contraindication against donation. Her 46-year-old brother suffered from high-risk multiple myeloma and was scheduled for allo-SCT after conditioning with melphalan/fludarabine/alemtuzumab.2 We started mobilization with G-CSF in a dosage of 5 μg/kg s.c. two times a day, 5 days before leukapheresis.3 CD34+ cell count in blood was determined by flow cytometry.4 At time of first leukapheresis, we found insufficient mobilization of CD34+ stem cells into the peripheral blood; the CD34 count was 14 cells per μL with total leukocytes of 21.6 Gpt/L. Concurrently, during the first leukapheresis, we were unable to collect a sufficient amount of CD34+ stem cells; the apheresis yielded only 23.9 × 106 CD34+ cells, equivalent to 0.32 × 106 CD34+ cells per kg body weight of the recipient.

In spite of continued application of G-CSF, the CD34+ cell count in the peripheral blood decreased to 4 cells per μL and 3 cells per μL during the next 2 days; hence, we had to accept that we were unable to mobilize an adequate number of CD34+ stem cells with G-CSF alone. A conventional BM harvest was refused by the donor. Initiation of a search for an unrelated donor was not an option as the conditioning of the recipient was completed. The harvested stem cells were transplanted.

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References

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  1. Internal Medicine C (Haematology and Oncology, Transplant Centre), Ernst-Moritz-Arndt-University, Greifswald, Germany

    T Neumann, W H Krüger, C Busemann, T Kiefer & G Dölken

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  1. T Neumann
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  2. W H Krüger
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  3. C Busemann
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  4. T Kiefer
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  5. G Dölken
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Correspondence to W H Krüger.

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Neumann, T., Krüger, W., Busemann, C. et al. Successful mobilization of PBSCs in a healthy volunteer donor by addition of plerixafor after failure of mobilization with G-CSF alone. Bone Marrow Transplant 46, 762–763 (2011). https://doi.org/10.1038/bmt.2010.178

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