Plerixafor combined with G-CSF for stem cell mobilization in children qualified for autologous transplantation- single center experience

Abstract

Failure of autologous peripheral blood CD34⁺ stem cells collection can adversely affect the treatment modality for patients with hematological and nonhematological malignant diseases where high dose chemotherapy followed by hematopoietic stem cell transplantation has become part of their treatment. Plerixafor in conjunction with G-CSF is approved for clinical use as a mobilization agent. The clinical efficacy of Plerixafor in CD34⁺ cells collection was analyzed in our institution. A total of 13 patients aged 1-15,5 years received Plerixafor in combination with G-CSF: 7 with neuroblastoma, 2 with Ewing's sarcoma and single patients with Hodgkin's lymphoma, germ cell tumor, retinoblastoma and Wilms tumor. Twelve patients (923%) achieved CD34+ cell counts of ≥ 20 × 10⁶/L after 1-7 doses of Plerixafor. The average 9,9 - fold increase in number of CD34⁺ cells were achieved following the first dose and 429 - fold after second dose of plerixafor. Among the 13 patients, 12 yielded the minimum required cell collection of 2 × 10⁶/kg within an average of 2 doses of Plerixafor. The mean number of apheresis days was 1.75. The median total number of collected CD34⁺ cells was 982 × 10⁶/kg. Plerixafor enables rapid and effective mobilization, and collection of sufficient number of CD34⁺ cells.

Keywords: Autologous peripheral blood CD34(+) stem cells; Autologous stem cell transplantation; Mobilization in children; Plerixafor.