Mobilization with chemotherapy + G-CSF + plerixafor in Europe: The Italian experience

Roberto M. Lemoli, Alessandra D' Addio

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The standard mobilization strategy in the majority of the European Transplant Centers involves the combination of disease-specific chemotherapy with granulocyte colony-stimulating factor (G-CSF) (chemomobilization) to obtain both the reduction of tumor burden and the mobilization of peripheral blood stem cells (PBSCs). However, a significant proportion of patients with lymphoid malignancies fail to mobilize enough PBSCs to proceed to autotransplantation. In this regard, chemomobilization does not prevent poor mobilization. Plerixafor (previously known as AMD 3100) has been shown to rapidly increase the number of circulating CD34+ stem/progenitor cells from marrow niches to the circulation when administered alone or in combination with G-CSF. There is limited experience on combining plerixafor with chemotherapy plus G-CSF in patients who mobilize poorly although current evidence suggests that the addition of plerixafor is safe and effective in the large majority of patients with low blood CD34+ cell counts after mobilization and/or poor yield after the first collection(s) (poor mobilizers). Therefore, the mechanism of action of plerixafor inducing the rapid release of CD34+ cells from the bone marrow to the peripheral blood makes this molecule suitable for its “preemptive” use in patients who are hard to mobilize.

Original languageEnglish
Title of host publicationNovel Developments in Stem Cell Mobilization: Focus on CXCR4
PublisherSpringer US
Pages302-332
Number of pages31
ISBN (Print)9781461419600, 9781461419594
DOIs
Publication statusPublished - Jan 1 2012

Keywords

  • Chemomobilization
  • Predicted poor mobilizer
  • Proven poor mobilizer

ASJC Scopus subject areas

  • Medicine(all)

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