Plerixafor ‘just in time’ for stem cell mobilization in a normal donor

Female donors and donors who are lighter than their recipient are less likely to meet the CD34+ cell dose requested for peripheral blood stem cell transplantation

“…Plerixafor, a direct antagonist of CXCR4/stromal‐derived factor 1, may be of benefit in groups at risk of poor mobilization, but is currently only licensed for autologous donations. Studies using plerixafor in unrelated donors are limited, some have used plerixafor in monotherapy, and others in combination with G‐CSF . Devine and colleagues showed that a mobilization regimen with plerixafor alone results in lower numbers of CD34+ cells in the stem cell products compared to G‐CSF–mobilized products.…”

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

“…Two reports have described plerixafor rescue in sibling donors, who both failed to have adequate PBSCs harvested while their recipients had already undergone myeloablative conditioning . Both successfully engrafted.…”

“…Plerixafor is licensed in the EU for autologous PBSC mobilization in myeloma or non‐Hodgkin's lymphoma patients who fail standard PBSCH . Two successful cases of plerixafor “rescue” after failure to harvest adequate CD34+ PBSCs from healthy sibling donors after standard G‐CSF priming are described . We describe herein the first case of failed engraftment after a seemingly successful plerixafor rescue.…”

“…4 Two successful cases of plerixafor "rescue" after failure to harvest adequate CD34+ PBSCs from healthy sibling donors after standard G-CSF priming are described. 5,6 We describe herein the first case of failed engraftment after a seemingly successful plerixafor rescue.…”

Addition of plerixafor for CD34+ cell mobilization in six healthy stem cell donors ensured satisfactory grafts for transplantation

“…Currently, the use of plerixafor in healthy allogeneic donors is off‐label with only three cases describing the use of plerixafor as a supplement to G‐CSF. In two of these cases plerixafor was added as “just‐in time” after mobilization failure with G‐CSF alone, and in one case G‐CSF and plerixafor were used as single doses subsequent to marrow harvest failure . Apart from using plerixafor as a supplement to G‐CSF, Devine and coworkers demonstrated that a single dose of plerixafor administered as monotherapy could mobilize sufficient peripheral HSCs in HLA‐matched sibling donors.…”