Plerixafor use in patients with previous mobilization failure: A multicenter experience

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• Hematopoietic stem cell mobilization is crucial for autologous stem cell transplantation (ASCT).
• Mobilization failure occurs in a subset of patients, necessitating alternative strategies.
• G-CSF alone or with chemotherapy can fail to achieve adequate stem cell collection.

Purpose of the Study:

• To evaluate the efficacy and safety of plerixafor plus G-CSF (G-P) in patients with prior mobilization failure.
• To assess the success rate of stem cell collection and subsequent ASCT in this patient cohort.

Main Methods:

• Retrospective analysis of 20 consecutive lymphoma and myeloma patients across five centers.
• Patients had at least one prior mobilization failure with G-CSF alone or G-CSF plus chemotherapy.
• Plerixafor was administered in conjunction with G-CSF.

Main Results:

• Successful collection of ≥2×10^6/kg CD34+ stem cells in 14 out of 20 patients (70%).
• 16 out of 20 patients (80%) proceeded to autologous stem cell transplantation (ASCT).
• Plerixafor demonstrated a safe rescue profile in patients with mobilization failure history.

Conclusions:

• Plerixafor in combination with G-CSF is an effective rescue strategy for patients experiencing hematopoietic stem cell mobilization failure.
• This approach significantly improves the chances of proceeding to ASCT after prior mobilization setbacks.
• G-P offers a safe and viable option for managing difficult-to-mobilize stem cells in lymphoma and myeloma patients.