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Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells.

Publication ,  Journal Article
Chen, Y-B; Le-Rademacher, J; Brazauskas, R; Kiefer, DM; Hamadani, M; DiPersio, JF; Litzow, MR; Craig, M; Horwitz, ME; Artz, AS; McClune, BL ...
Published in: Blood Adv
March 26, 2019

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.

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Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

March 26, 2019

Volume

3

Issue

6

Start / End Page

875 / 883

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Tissue Donors
  • Siblings
  • Middle Aged
  • Humans
  • Histocompatibility
  • Heterocyclic Compounds
  • Hematopoietic Stem Cell Transplantation
  • Hematopoietic Stem Cell Mobilization
 

Citation

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MLA
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Chen, Y.-B., Le-Rademacher, J., Brazauskas, R., Kiefer, D. M., Hamadani, M., DiPersio, J. F., … Devine, S. M. (2019). Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells. Blood Adv, 3(6), 875–883. https://doi.org/10.1182/bloodadvances.2018027599
Chen, Yi-Bin, Jennifer Le-Rademacher, Ruta Brazauskas, Deidre M. Kiefer, Mehdi Hamadani, John F. DiPersio, Mark R. Litzow, et al. “Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells.Blood Adv 3, no. 6 (March 26, 2019): 875–83. https://doi.org/10.1182/bloodadvances.2018027599.
Chen Y-B, Le-Rademacher J, Brazauskas R, Kiefer DM, Hamadani M, DiPersio JF, et al. Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells. Blood Adv. 2019 Mar 26;3(6):875–83.
Chen, Yi-Bin, et al. “Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells.Blood Adv, vol. 3, no. 6, Mar. 2019, pp. 875–83. Pubmed, doi:10.1182/bloodadvances.2018027599.
Chen Y-B, Le-Rademacher J, Brazauskas R, Kiefer DM, Hamadani M, DiPersio JF, Litzow MR, Craig M, Horwitz ME, Artz AS, McClune BL, Fernandez HF, Duong HK, Kobusingye H, Proue M, Drexler RJ, Horowitz MM, Shaw BE, Miller JP, Hosoba S, Waller EK, Devine SM. Plerixafor alone for the mobilization and transplantation of HLA-matched sibling donor hematopoietic stem cells. Blood Adv. 2019 Mar 26;3(6):875–883.

Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

March 26, 2019

Volume

3

Issue

6

Start / End Page

875 / 883

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Tissue Donors
  • Siblings
  • Middle Aged
  • Humans
  • Histocompatibility
  • Heterocyclic Compounds
  • Hematopoietic Stem Cell Transplantation
  • Hematopoietic Stem Cell Mobilization