Plerixafor and Filgrastim XM02 (Tevagastrim) as a first line peripheral blood stem cell mobilisation strategy in patients with multiple myeloma and lymphoma candidated to autologous bone marrow transplantation

Eur J Haematol. 2012 Feb;88(2):154-8. doi: 10.1111/j.1600-0609.2011.01719.x. Epub 2011 Nov 17.

Abstract

Plerixafor, a CXCR4 antagonist, has shown to be effective in increasing the number of circulating stem cells, even in patients failing a previous mobilisation attempt. Recently a number of non-glycosylated recombinant human granulocyte-colony stimulating factor (G-CSF) has been clinically approved for the same indications as the originator G-CSF for comparable safety and efficacy and their reduced cost. In an attempt to provide a less toxic strategy, 14 patients affected by haematological malignancies (non-Hodgkin's lymphoma = 4, Hodgkin's disease = 2 and multiple myeloma = 8), received the combination of biosimilar filgrastim and plerixafor as a first line mobilising strategy. The median number of circulating CD34+ cells on day 4 was 16 (3-42); Plerixafor was administered to all, but one patient who had already 42 CD34+ cells per μL on day 4. On day 5, after plerixafor administration, the median number of circulating CD34+ cells had raised to 60 per μL (14-138). All the patients underwent leukapheresis and were able to collect a number of CD34+ cells ≥ 2.0 × 10(6) /kg in a median number of procedures of one. Although preliminary, these data show the combination of biosimilar filgrastim and plerixafor is effective and provides a non-toxic approach to mobilise stem cells.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD34 / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Benzylamines
  • Bone Marrow Transplantation*
  • Combined Modality Therapy
  • Cyclams
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Hematopoietic Stem Cell Mobilization / methods*
  • Heterocyclic Compounds / administration & dosage*
  • Heterocyclic Compounds / adverse effects
  • Humans
  • Lymphoma / surgery*
  • Male
  • Middle Aged
  • Multiple Myeloma / surgery*
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult

Substances

  • Antigens, CD34
  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim
  • plerixafor