Partial engraftment following plerixafor rescue after failed sibling donor peripheral blood stem cell harvest

Eyre, Toby A.; King, Andrew; Peniket, Andrew; Rocha, Vanderson; Collins, Graham P.; Pawson, Rachel

doi:10.1111/trf.12429

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…It cannot be expected that ad hoc salvage treatment with plerixafor after failed G-CSF mobilization will be successful in every poor mobilizing donor [ 25 ]. Earlier addition of plerixafor (e.g., starting on Day 3 of G-CSF application) might be more efficacious in some donors.…”

Section: Discussionmentioning

confidence: 99%

Salvage treatment with plerixafor in poor mobilizing allogeneic stem cell donors: results of a prospective phase II-trial

Hölig

Schmidt

Hütter³

et al. 2020

Bone Marrow Transplant

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We conducted a prospective clinical trial to investigate the safety and efficacy of plerixafor (P) in allogeneic peripheral blood stem cells (PBSC) donors with poor mobilization response to standard-dose granulocyte colony-stimulating factor (G-CSF), defined by <2 × 10 6 CD34 + cells/kg recipient body-weight (CD34+/kg RBW) after 1st apheresis. A single dose of 240 µg/kg P was injected subcutaneously at 10 p.m. on the day of the 1st apheresis. Thirty-seven allogeneic PBSC donors underwent study treatment. The median CD34+ count in peripheral blood was 15/µl on Day 1 after G-CSF alone, versus 44/µl on Day 2 after G-CSF plus P ( p < 0.001). The median yield of CD34+ cells was 1.1 × 10 8 on Day 1 and 2.8 × 10 8 on Day 2. In contrast to a median yield of only 1.31 × 10 6 CD CD34+/kg RBW on Day 1, triggering study inclusion, a median of 3.74 × 10 6 CD CD34+/kg RBW were collected with G-CSF plus P on Day 2. Of 37 donors, 21 reached the target cell count of >4.5 × 10 6 CD34+/kg RBW (57%, 95%CI 40–73%). No donor experienced a severe adverse event requiring treatment. In conclusion, P might be considered on a case-by-case basis for healthy allogeneic donors with very poor stem cell mobilization success after G-CSF.

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Section: Discussionmentioning

confidence: 99%

Salvage treatment with plerixafor in poor mobilizing allogeneic stem cell donors: results of a prospective phase II-trial

Hölig

Schmidt

Hütter³

et al. 2020

Bone Marrow Transplant

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“…Plerixafor has also been shown effective as a rescue agent in allogeneic donors initially mobilized with G‐CSF 2,15,20‐22,26,29,32‐36 . Most of these studies were either small case series with ≤10 subjects, 15,26 or single case reports 20‐22,29,36 which showed G‐CSF mobilization and rescue plerixafor resulted in increased CD34+ cell yield with successful collections.…”

Section: Discussionmentioning

confidence: 99%

“…In allogeneic donors there is a 2% to 4.6% collection failure rate (<2.0 × 10 6 CD34+ cells/kg recipient weight collected) using G‐CSF alone. Due to the small numbers of allogeneic donors who mobilize poorly, there are only case reports and small studies to support using plerixafor only 3,19,30,31 or in combination with G‐CSF 2,15,20‐22,26,29,32‐36 . All literature so far on low‐yield CD34+ donors mobilized with G‐CSF and plerixafor rescue in allogeneic donors have demonstrated increased CD34+ collection yield with plerixafor use 2,15,21,22,26,29,34‐36 .…”

Section: Introductionmentioning

confidence: 99%

“…Due to the small numbers of allogeneic donors who mobilize poorly, there are only case reports and small studies to support using plerixafor only 3,19,30,31 or in combination with G-CSF. 2,15,[20][21][22]26,29,[32][33][34][35][36] All literature so far on low-yield CD34+ donors mobilized with G-CSF and plerixafor rescue in allogeneic donors have demonstrated increased CD34+ collection yield with plerixafor use. 2,15,21,22,26,29,[34][35][36] At our medical center plerixafor has been used as a rescue agent for the past 8 years in allogeneic donors, with increased use in recent years.…”

Section: Introductionmentioning

confidence: 99%

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Addition of plerixafor in poorly mobilized allogeneic stem cell donors

Zhuang

Lauro

Wang

et al. 2022

J of Clinical Apheresis

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Background: Peripheral blood stem cells (PBSCs) are the predominant graft source for adult allogeneic hematopoietic stem cell transplantation (HSCT). In poorly mobilized autologous donors, plerixafor improves collection outcomes. We examine plerixafor use in allogeneic donors who mobilize poorly with granulocyte colony-stimulating factor (G-CSF) in those who are healthy and those with pre-existing medical conditions, and determine the optimal threshold to add plerixafor.Study Design/Methods: We retrospectively examined all allogeneic PBSC collections from January 2013 to October 2020 at our center. Donors received G-CSF 10 mcg/kg daily for 4 days before undergoing apheresis collection on day 5. Plerixafor was added based on poor CD34+ cell collection yield after the first or second collection day.Results: Of the 1008 allogeneic donors, 41 (4.1%) received one dose of plerixafor in addition to G-CSF due to poor collection yield. After starting plerixafor there was a 0.75-to 7.74-fold (median 2.94) increase in CD34+ yield from the previous day. No donors with G-CSF-only mobilization who collected <2.0 Â 10 6 CD34+ cells/kg recipient weight on day one achieved the goal of ≥4.0 Â 10 6 CD34+ cells/kg recipient weight total over 2 days but 59.2% of donors who used rescue plerixafor did.Conclusion: Donors both healthy and those with pre-existing disease responded well to plerixafor with minimal side effects. If the first-day collection yield is less than $63% of the collection goal, addition of plerixafor may be necessary to reach the collection goal and limit the number of collection days in allogeneic donors.

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“…The combined use of plerixafor and granulocyte-colony stimulating factor (G-CSF) improves mobilization in poor mobilizers. However, there are limited data available on the use of plerixafor in healthy donors [ 1 , 2 ]. The effects of influenza A infection on stem cell mobilization are not known.…”

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confidence: 99%

Use of Plerixafor to Mobilize a Healthy Donor Infected with Influenza A

Yeral¹,

Aytan²,

Boğa³

2018

Tjh

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Partial engraftment following plerixafor rescue after failed sibling donor peripheral blood stem cell harvest

Abstract: Rescue plerixafor to assist PBSCH in healthy allogeneic donors has been effective in terms of CD34+ cell number mobilized. It is unclear whether the partial engraftment seen was coincidental or related to a difference in PBSC quality.

Cited by 6 publications

References 17 publications

Salvage treatment with plerixafor in poor mobilizing allogeneic stem cell donors: results of a prospective phase II-trial

Salvage treatment with plerixafor in poor mobilizing allogeneic stem cell donors: results of a prospective phase II-trial

Addition of plerixafor in poorly mobilized allogeneic stem cell donors

Use of Plerixafor to Mobilize a Healthy Donor Infected with Influenza A

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