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    Plerixafor Salvage Is Safe and Effective in Hard-to-Mobilize Patients Undergoing Chemotherapy and Filgrastim-Based Peripheral Blood Progenitor Cell Mobilization

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    Authors
    Awan, Farrukh T.
    Kochuparambil, S. Thomas
    DeRemer, David
    Cumpston, Aaron
    Craig, Michael
    Jillella, Anand
    Hamadani, Mehdi
    Issue Date
    2012-04-10
    URI
    http://hdl.handle.net/10675.2/787
    
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    Abstract
    The combination of filgrastim (G-CSF) and plerixafor is currently approved for mobilizing peripheral blood progenitor cells in patients with non-Hodgkin lymphoma and multiple myeloma undergoing autologous peripheral blood hematopoietic cell transplantation. However, chemotherapy and G-CSF-based mobilization remains a widely used strategy for peripheral blood progenitor cell collection. In this paper we describe our experience from two North American transplant centers in a series of patients who received salvage plerixafor while failing chemotherapy and G-CSF mobilization. Patients received a median of two doses of plerixafor salvage upon failure to mobilize adequate number of peripheral blood progenitor cells at neutrophil recovery. The use of plerixafor was associated with a 2.4-fold increase in peripheral blood CD34+ cell count and 3.9-fold increase in total CD34+ cell yield. All patients were able to collect â ¥2 Ã 106 CD34+â cells/kg with this approach. These results were more pronounced in patients with a higher CD34+ cell count at the time of the first plerixafor dose. Interestingly, peripheral blood white blood cell count was not shown to correlate with a response to plerixafor. Our results provide safety and efficacy data for the use of plerixafor in patients who are destined to fail chemomobilization.
    Citation
    J Oncol. 2012 Apr 10; 2012:931071
    ae974a485f413a2113503eed53cd6c53
    10.1155/2012/931071
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    Department of Medicine Faculty: Research and Presentations

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