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Stem Cell Procurement

Efficacy and safety of hematopoietic stem cell remobilization with plerixafor+G-CSF in adult patients with germ cell tumors

Bone Marrow Transplantation volume 47, pages 1283–1286 (2012)Cite this article

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Abstract

Autologous hematopoietic SCT (auto-HSCT) can be curative for patients with germ cell tumors. Poor stem cell mobilization jeopardizes the ability to deliver this therapy. Herein, we describe a retrospective study examining safety and efficacy of plerixafor in combination with G-CSF for patients with germ cell tumors who had previously failed stem cell collection. Overall, 21 patients with germ cell tumors and previous mobilization failure were remobilized with G-CSF (10 μg/kg SC) and plerixafor (0.24 mg/kg SC) beginning the evening of day 4 of G-CSF treatment. Dosing of G-CSF and plerixafor was repeated until collection of ⩾2 × 106 CD34+ cells/kg. Remobilization resulted in a median yield of 3.2 × 106 CD34+ cells/kg. A total of 17 (81%) patients collected ⩾2 × 106 and 9 (43%) patients collected ⩾4 × 106 CD34+ cells/kg in a median of 2 (range 1–3) and 3 (range 1–4) days, respectively. In all, 16 (76%) patients proceeded to transplant; 8 (38%) received tandem transplants. There were no serious adverse events. In summary, the majority of patients with germ cell tumors who failed prior mobilization with growth factors ± chemotherapy were remobilized with plerixafor plus G-CSF facilitating at least one auto-HSCT. Use of plerixafor plus G-CSF can increase access of this potentially life-saving procedure to patients with high-risk germ cell tumors.

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Authors and Affiliations

  1. Department of Medicine, Divison of Cellular Therapy, Duke University Medical Center, Durham, NC, USA

    M E Horwitz & G Long

  2. University of California-San Diego, La Jolla, CA, USA

    P Holman

  3. Division of Medical Oncology, University of Washington, Seattle Cancer Care Alliance/FHCRC, Seattle, WA, USA

    E Libby

  4. Genzyme Corporation, Cambridge, MA, USA

    G C Calandra

  5. Banner Blood and Marrow Transplant Program, Phoenix, AZ, USA

    J R Schriber

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  1. M E Horwitz
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  2. G Long
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Correspondence to M E Horwitz.

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Competing interests

Mitchell Horwitz, Gary Calandra and Jeffrey Schriber have relevant financial relationships as follows; Genzyme, Honoraria (JS); Genzyme, Honoraria and Research Funding (MH); Genzyme, paid consultant (GC). The other authors declare no conflict of interest.

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Horwitz, M., Long, G., Holman, P. et al. Efficacy and safety of hematopoietic stem cell remobilization with plerixafor+G-CSF in adult patients with germ cell tumors. Bone Marrow Transplant 47, 1283–1286 (2012). https://doi.org/10.1038/bmt.2012.21

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  • DOI: https://doi.org/10.1038/bmt.2012.21

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