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Related Concept Videos

Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...

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Intrafemoral Injection of Human Hematopoietic Stem and Progenitor Cells into Immunocompromised Mice
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Plerixafor in poor stem cell mobilizers: the Belgian Compassionate Use Program.

D Selleslag1, D Dierickx, D A Breems

  • 1Department of Hematology, AZ Sint-Jan Brugge-Oostende, Brugge. Dominik.Selleslag@azbrugge.be

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|August 16, 2011
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Plerixafor combined with G-CSF successfully mobilizes stem cells in patients who previously failed mobilization, including heavily pretreated individuals. This strategy offers a new hope for poor stem cell mobilizers, achieving a 64% success rate.

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Area of Science:

  • Hematology
  • Stem Cell Transplantation
  • Pharmacology

Background:

  • Current stem cell mobilization regimens (G-CSF +/- chemotherapy) have high failure rates, particularly in heavily pretreated patients.
  • Plerixafor, an antagonist of the CXCR4-SDF-1 interaction, presents a novel approach for stem cell mobilization.
  • This study evaluates the efficacy of plerixafor within the Belgian compassionate use program (CUP).

Purpose of the Study:

  • To assess the effectiveness of plerixafor in combination with G-CSF for stem cell mobilization in patients with a history of mobilization failure.
  • To evaluate the outcomes in poor stem cell mobilizers, including those heavily pretreated, within a compassionate use setting.

Main Methods:

  • A total of 22 poor stem cell mobilizers participated in the Belgian CUP across 14 transplant centers.
  • Patients received a combination of G-CSF and plerixafor, followed by apheresis.
  • Mobilization continued until at least 2 x 10(6)/kg CD34+ cells were collected, with a maximum of 3 apheresis days.

Main Results:

  • An average of 2 plerixafor administrations were required to achieve the target CD34+ cell count.
  • The overall success rate for stem cell collection was 64% after a maximum of 3 apheresis days.
  • Fifty percent of heavily pretreated patients (>= 3 prior chemotherapy regimens) and 75% of patients receiving <= 2 prior regimens were successfully mobilized.

Conclusions:

  • The combination of plerixafor and G-CSF is an effective stem cell mobilization strategy for patients with prior mobilization failure.
  • This approach demonstrates success even in poor mobilizers who have undergone extensive prior chemotherapy.
  • Successful stem cell mobilization facilitated autologous transplantation in 59.1% of patients with normal recovery times.