A trial of plerixafor adjunctive therapy in allogeneic hematopoietic cell transplantation with minimal conditioning for severe combined immunodeficiency

Pediatr Transplant. 2014 Sep;18(6):602-8. doi: 10.1111/petr.12309. Epub 2014 Jun 30.

Abstract

For infants with SCID, the ideal conditioning regimen before allogeneic HCT would omit cytotoxic chemotherapy to minimize short- and long-term complications. We performed a prospective pilot trial with G-CSF plus plerixafor given to the host to mobilize HSC from their niches. We enrolled six patients who received CD34-selected haploidentical cells and one who received T-replete matched unrelated BM. All patients receiving G-CSF and plerixafor had generally poor CD34(+) cell and Lin(-) CD34(+) CD38(-) CD90(+) CD45RA(-) HSC mobilization, and developed donor T cells, but no donor myeloid or B-cell engraftment. Although well tolerated, G-CSF plus plerixafor alone failed to overcome physical barriers to donor engraftment.

Keywords: engraftment; haploidentical; plerixafor; severe combined immunodeficiency.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Benzylamines
  • California
  • Chemotherapy, Adjuvant
  • Child
  • Combined Modality Therapy
  • Cyclams
  • Drug Therapy, Combination
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematopoietic Stem Cell Mobilization
  • Hematopoietic Stem Cell Transplantation*
  • Heterocyclic Compounds / therapeutic use*
  • Histocompatibility Testing
  • Humans
  • Infant
  • Male
  • Pilot Projects
  • Prospective Studies
  • Severe Combined Immunodeficiency / drug therapy
  • Severe Combined Immunodeficiency / immunology
  • Severe Combined Immunodeficiency / therapy*
  • Transplantation Conditioning
  • Treatment Outcome

Substances

  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • Granulocyte Colony-Stimulating Factor
  • plerixafor