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Related Experiment Video

Updated: May 22, 2026

Simplified Intrafemoral Injections Using Live Mice Allow for Continuous Bone Marrow Analysis
06:28

Simplified Intrafemoral Injections Using Live Mice Allow for Continuous Bone Marrow Analysis

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Clinical experience with a simple algorithm for plerixafor utilization in autologous stem cell mobilization.

A I Chen1, T Bains, S Murray

  • 1Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA. chenan@ohsu.edu

Bone Marrow Transplantation
|May 8, 2012
PubMed
Summary

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A new guideline using day 4 CD34+ cell counts effectively guides plerixafor use in stem cell mobilization. This approach minimizes mobilization failures and ensures adequate peripheral blood stem cell (PBSC) collection for autologous transplants.

Area of Science:

  • Hematology
  • Transplantation Immunology
  • Clinical Medicine

Background:

  • Plerixafor enhances peripheral blood stem cell (PBSC) collection but its optimal integration into mobilization protocols remains unclear.
  • Granulocyte-colony stimulating factor (G-CSF) is a standard agent for PBSC mobilization.
  • Predicting apheresis yield is crucial for successful autologous transplantation.

Purpose of the Study:

  • To develop and evaluate a clinical guideline for the preemptive use of plerixafor based on early peripheral blood CD34+ cell counts.
  • To minimize mobilization failures and optimize PBSC collection for autologous transplantation.

Main Methods:

  • Retrospective analysis of 49 patients mobilized with G-CSF alone to identify a predictive threshold for CD34+ cell count.
  • Development of a guideline recommending plerixafor use when day 4 CD34+ cell counts fall within a specific range.

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  • Prospective evaluation of the guideline in 166 patients with lymphoma or plasma cell dyscrasias.

    • Main Results:

    • A day 4 peripheral blood CD34+ cell count of >0.015/ml predicted sufficient PBSC yield with G-CSF alone.
    • The guideline recommended plerixafor for counts between 0.005-0.015/ml.
    • Mobilization failure rate was 7% in patients managed per guideline, with median yields of 6.3 × 10(6) CD34+ progenitors/kg (G-CSF alone) and 4.9 × 10(6) CD34+ progenitors/kg (G-CSF+plerixafor).

    Conclusions:

    • The developed clinical guideline is an effective algorithm for plerixafor-guided PBSC mobilization.
    • This approach minimizes mobilization failures and optimizes apheresis yields.
    • The guideline is simple to implement and does not require identification of specific risk factors.