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Stem Cell Procurement

Preemptive dosing of plerixafor given to poor stem cell mobilizers on day 5 of G-CSF administration

Bone Marrow Transplantation volume 47, pages 1051–1055 (2012)Cite this article

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Abstract

Plerixafor, given on day 4 of G-CSF treatment is more effective than G-CSF alone in mobilizing hematopoietic progenitor cells. We tested a strategy of preemptive plerixafor use following assessment of the peak mobilization response to 5 days of G-CSF. Patients were eligible for plerixafor if, on day 5 of G-CSF, there were <7 circulating CD34+ cells/μL or if <1.3 × 106 CD34+ cells/kg were collected on the first day of apheresis. Plerixafor (0.24 mg/kg s.c.) was given on day 5 of G-CSF followed by apheresis on day 6. This was repeated for up to two additional doses of plerixafor. The primary end point of the study was the percentage of patients who collected at least 2 × 106 CD34+ cells/kg. Twenty candidates for auto-SCT enrolled on the trial. The circulating CD34+ cell level increased a median of 3.1 fold (range 1–8 fold) after the first dose of plerixafor and a median of 1.2 fold (range 0.3–6.5 fold) after the second dose of plerixafor. In all, 15 out of 20 (75%) patients achieved the primary end point. In conclusion, the decision to administer plerixafor can be delayed until after the peak mobilization response to G-CSF has been fully assessed.

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Acknowledgements

We would like to thank the apheresis staff of the Duke Adult Stem Cell Transplant Program for their outstanding work and contribution to this study. Research funding for this study was supported by Genzyme Corporation.

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  1. Division of Cellular Therapy, Department of Medicine, Adult Stem Cell Transplant Program, Duke University Medical Center, Durham, NC, USA

    M E Horwitz, J P Chute, C Gasparetto, G D Long, C McDonald, A Morris, D A Rizzieri, K M Sullivan & N J Chao

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  1. M E Horwitz
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  2. J P Chute
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  3. C Gasparetto
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  8. K M Sullivan
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Correspondence to M E Horwitz.

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NJC and MEH have relevant financial relationships as follows; Genzyme and Research Funding (NJC), and Genzyme, Honoraria and Research Funding (MH). Other authors have no relevant financial relationship to disclose.

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Horwitz, M., Chute, J., Gasparetto, C. et al. Preemptive dosing of plerixafor given to poor stem cell mobilizers on day 5 of G-CSF administration. Bone Marrow Transplant 47, 1051–1055 (2012). https://doi.org/10.1038/bmt.2011.217

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