Back to Search
Start Over
Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells
- Source :
- Blood Advances. 3:875-883
- Publication Year :
- 2019
- Publisher :
- American Society of Hematology, 2019.
-
Abstract
- Plerixafor, a direct antagonist of CXCR4/stromal-derived factor 1, can safely and rapidly mobilize allografts without the use of granulocyte colony-stimulating factor (G-CSF). We conducted a phase 2, multicenter, prospective study of plerixafor-mobilized HLA-identical sibling allografts for allogeneic hematopoietic cell transplantation in recipients with hematological malignancies. Donors (n = 64) were treated with subcutaneous plerixafor (240 µg/kg) and started leukapheresis (LP) 4 hours later. The primary objective was to determine the proportion of donors who were successfully mobilized: defined as collection of ≥2.0 × 106 CD34+ cells per kilogram recipient weight in ≤2 LP sessions. Recipients subsequently received reduced intensity (RIC; n = 33) or myeloablative (MAC; n = 30) conditioning. Sixty-three of 64 (98%) donors achieved the primary objective. The median CD34+ cell dose per kilogram recipient weight collected within 2 days was 4.7 (0.9-9.6). Plerixafor was well tolerated with only grade 1 or 2 drug-related adverse events noted. Bone pain was not observed. Plerixafor-mobilized grafts engrafted promptly. One-year progression-free and overall survivals were 53% (95% confidence interval [CI], 36% to 71%) and 63% (95% CI, 46% to 79%) for MAC and 64% (95% CI, 47% to 79%) and 70% (95% CI, 53% to 84%) for RIC recipients, respectively. Donor toxicity was reduced relative to G-CSF mobilized related donors. This is the first multicenter trial to demonstrate that, as an alternative to G-CSF, plerixafor rapidly and safely mobilizes sufficient numbers of CD34+ cells from matched sibling donors for HCT. Engraftment was prompt, and outcomes in recipients were encouraging. This trial was registered at clinicaltrials.gov as #NCT01696461.
- Subjects :
- Adult
Benzylamines
medicine.medical_specialty
Antigens, CD34
Cyclams
CXCR4
Gastroenterology
Heterocyclic Compounds
Internal medicine
Multicenter trial
medicine
Humans
Transplantation, Homologous
Prospective cohort study
Aged
Transplantation
business.industry
Siblings
Plerixafor
Hematopoietic Stem Cell Transplantation
Hematology
Leukapheresis
Middle Aged
Hematopoietic Stem Cell Mobilization
Tissue Donors
Histocompatibility
Granulocyte colony-stimulating factor
Treatment Outcome
Hematologic Neoplasms
business
medicine.drug
Subjects
Details
- ISSN :
- 24739537 and 24739529
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Blood Advances
- Accession number :
- edsair.doi.dedup.....846c9bfb98397acc50a046440c18a7d9