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

Efficacy of plerixafor in children with malignant tumors failing to mobilize a sufficient number of hematopoietic progenitors with G-CSF

Bone Marrow Transplantation volume 50, pages 1089–1091 (2015)Cite this article

Subjects

Abstract

Mobilization of suitable amounts of PBSCs with granulocyte-CSF (G-CSF) can be difficult in children. We report the results of using plerixafor in pediatric patients who failed to mobilize progenitors with G-CSF-based regimens. Thirty-three patients, median age 9 years (range 1–18 years) and median weight 29 kg (range 10–85 kg) were enrolled into the study. After 4 days of G-CSF stimulation, the median CD34+ cell count in peripheral blood was 10.4 per μL (range 0.27–23.0 per μL). Plerixafor was administered subcutaneously (0.24 μg/kg in 30 patients and 0.3 μg/kg in 3 patients) 11–12 h before apheresis. At the time of apheresis, CD34+ cell counts increased to a median of 44.1 per μL (range 8.4–357.0 per μL), a median 4.4-fold increase. Two patients (6%) failed to mobilize. Thirty-one patients underwent apheresis and in 27 >2 × 106 CD34+ cells per kg of body weight were collected after one procedure. In total, 31 of 33 patients mobilized successfully and the median number of cryopreserved CD34+ cells was 5.6 × 106 /kg body weight (2.7 × 106–27.4 × 106). Twenty-four patients underwent transplantation. Engraftment was achieved in all but one patient, who died on day +9 after hematopoietic stem cell transplantation. The median time of neutrophil and platelet recovery was day +12 and +16, respectively. Our study confirms that plerixafor has impressive efficacy and very modest toxicity in children.

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

Figure 1

Similar content being viewed by others

References

  1. Baldomero H, Gratwohl M, Gratwohl A, Tichelli A, Niederwieser D, Madrigal A et al. The EBMT activity survey 2009: trends over the past 5 years. Bone Marrow Transplant 2011; 46: 485–501.

    Article  CAS  Google Scholar 

  2. Kuittinen T, Nousiainen T, Halonen P, Mahlamäki E, Jantunen E . Prediction of mobilization failure in patients with non-Hodgkin's lymphoma. Bone Marrow Transplant 2004; 33: 907–912.

    Article  CAS  Google Scholar 

  3. Ferraro F, Lymperi S, Méndez-Ferrer S, Saez B, Spencer JA, Yeap BY et al. Diabetes impairs hematopoietic stem cell mobilization by altering niche function. Sci Transl Med 2011; 3: 104ra101.

    Article  Google Scholar 

  4. Gertz MA, Wolf RC, Micallef INM, Gastineau DA . Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma. Bone Marrow Transplant 2010; 45: 1396–1403.

    Article  CAS  Google Scholar 

  5. Hosing C, Saliba RM, Ahlawat S, Körbling M, Kebriaei P, Alousi A et al. Poor hematopoietic stem cell mobilizers: a single institution study of incidence and risk factors in patients with recurrent or relapsed lymphoma. Am J Hematol 2009; 84: 335–337.

    Article  CAS  Google Scholar 

  6. Molineux G, Pojda Z, Hampson IN, Lord BI, Dexter TM . Transplantation potential of peripheral blood stem cells induced by granulocyte colony-stimulating factor. Blood 1990; 76: 2153–2158.

    CAS  PubMed  Google Scholar 

  7. Devine SM, Flomenberg N, Vesole DH, Liesveld J, Weisdorf D, Badel K et al. Rapid mobilization of CD34+ cells following administration of the CXCR4 antagonist AMD3100 to patients with multiple myeloma and non-Hodgkin's lymphoma. J Clin Oncol 2004; 22: 1095–1102.

    Article  CAS  Google Scholar 

  8. Fowler CJ, Dunn A, Hayes-Lattin B, Hansen K, Hansen L, Lanier K et al. Rescue from failed growth factor and/or chemotherapy HSC mobilization with G-CSF and plerixafor (AMD3100): an institutional experience. Bone Marrow Transplant 2009; 43: 909–917.

    Article  CAS  Google Scholar 

  9. Devine SM, Vij R, Rettig M, Todt L, McGlauchlen K, Fisher N et al. Rapid mobilization of functional donor hematopoietic cells without G-CSF using AMD3100, an antagonist of the CXCR4/SDF-1 interaction. Blood 2008; 112: 990–998.

    Article  CAS  Google Scholar 

  10. Fruehauf S, Veldwijk MR, Seeger T, Schubert M, Laufs S, Topaly J et al. A combination of granulocyte-colony-stim- ulating factor (G-CSF) and plerixafor mobilizes? more primitive peripheral blood progenitor cells? than G-CSF alone: results of a European phase II? study. Cytotherapy 2009; 11: 992–1001.

    Article  CAS  Google Scholar 

  11. Fruehauf S . Current clinical indication for plerixafor. Transfus Med Hemother 2013; 40: 246–250.

    Article  Google Scholar 

  12. Emir S, Demir HA, Aksu T, Kara A, Özgüner M, Tunç B . Use of plerixafor forperipheral blood stem cell mobilization failure in children. Transfus Apher Sci 2014; 50: 214–218.

    Article  Google Scholar 

  13. Hong KT, Kang HJ, Kim NH, Kim MS, Lee JW, Kim H et al. Successful mobilization using a combination of plerixafor and G-CSF in pediatric patients who failed previous chemomobilization with G-CSF alone and possible complications of the treatment. J Hematol Oncol 2012; 5: 14.

    Article  CAS  Google Scholar 

  14. Vettenranta K, Möttönen M, Riikonen P . The use of plerixafor in harvesting autologous stem cells in the pediatric setting. Pediatr Blood Cancer 2012; 59: 197–198.

    Article  Google Scholar 

  15. Modak S, Cheung IY, Kushner BH, Kramer K, Reich L, Cheung NK . Plerixafor plus granulocyte-colony stimulating factor for autologous hematopoietic stem cell mobilization in patients with metastatic neuroblastoma. Pediatr Blood Cancer 2012; 58: 469–471.

    Article  Google Scholar 

  16. Toledano H, Yahel A, Cohen IJ, Yaniv I, Stein J . Successful mobilization,harvest and transplant of peripheral blood stem cells using AMD3100 and G-CSFfollowing high dose craniospinal irradiation for medulloblastoma in a young child. Pediatr Blood Cancer 2010; 54: 613–615.

    PubMed  Google Scholar 

  17. Aabideen K, Anoop P, Ethell ME, Potter MN . The feasibility of plerixafor as a second-line stem cell mobilizing agent in children. J Pediatr Hematol Oncol 2011; 33: 65–67.

    Article  Google Scholar 

  18. McCullough J, Clay M, Herr G, Smith J, Stroncek D . Effects of granulocyte-colony-stimulating factor on potential normal granulocyte donors. Transfusion 1999; 39: 1136–1140.

    Article  CAS  Google Scholar 

  19. Choi S, Rajan SS, Trivedi MV . The incidence of tumor cell contamination of peripheral blood stem cells: a meta-analysis to evaluate the impact of mobilization regimens and the influence on outcomes in breast cancer patients. Acta Haematol 2014; 131: 133–140.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dmitrii Rogachev Federal Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia

    A A Maschan, D N Balashov, E E Kurnikova, P E Trakhtman, E V Boyakova, G A Novichkova & M A Maschan

  2. BMT Department, Russian Children’s Hospital, Moscow, Russia

    E V Skorobogatova

Authors
  1. A A Maschan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D N Balashov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E E Kurnikova
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P E Trakhtman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E V Boyakova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E V Skorobogatova
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G A Novichkova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M A Maschan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M A Maschan.

Ethics declarations

Competing interests

AAM has received speaker’s fees from Sanofi during previous years for educational lectures not concerning topic of the presented study. The remaining authors declared no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maschan, A., Balashov, D., Kurnikova, E. et al. Efficacy of plerixafor in children with malignant tumors failing to mobilize a sufficient number of hematopoietic progenitors with G-CSF. Bone Marrow Transplant 50, 1089–1091 (2015). https://doi.org/10.1038/bmt.2015.71

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2015.71

This article is cited by

Search

Advanced search

Quick links