The current opinion on the place of plerixafor in hematopoietic stem cell mobilization

Abstract

Plerixafor is a specific antagonist of the CXCR4 chemokine receptor used for mobilization of hematopoietic stem cells from bone marrow to peripheral blood for their collection and subsequent transplantation. The European label indications include patients with lymphoma and multiple myeloma whose cells mobilise poorly. Because of its high efficacy when used in combination with G-CSF, it has been used mainly in patients with failed previous mobilization (“failed mobilizers”). However, label indications include plerixafor usage also in patients predicted to mobilize poorly (“predicted poor mobilizers”) as well as those with suboptimal current mobilization (“proven poor mobilizers”). Also patients who mobilize efficiently (“good mobilizers”) might benefit from mobilization with plerixafor. The paper demonstrates the use of plerixafor in above situations. Also a “rescue” strategy of plerixafor use during stem cell mobilization is presented.