Plerixafor In Patients with Non-Hodgkin's Lymphoma or Multiple Myeloma

The bicyclam plerixafor mobilizes haematopoietic stem cells (HSCs) from the bone marrow into the peripheral blood circulation and augments the effects of granulocyte colony-stimulating factor (G-CSF). More patients requiring autologous HSC transplantation for non-Hodgkin's lymphoma or multiple myeloma in first or second remission achieved goal increases in mobilized CD34+ cells after subcutaneous plerixafor 240 mu g/kg/day for up to four apheresis days in conjunction with a G-CSF treatment regimen than after placebo plus G-CSF. Sufficient CD34+ cells for transplantation were collected earlier for recipients of plerixafor plus G-CSF (often after one apheresis) than for patients receiving placebo plus G-CSF. Time to engraftment and durability of grafts after 12 months were similar for both plerixafor plus G-CSF and placebo plus G-CSF. In a compassionate-use trial in patients with non-Hodgkin's lymphoma, multiple myeloma or Hodgkin's disease in whom prior mobilization attempts were unable to stimulate sufficient cells, therapy with the plerixafor/G-CSF combination regimen was successful in >= 60% of patients. Plerixafor appears to be generally well tolerated; most adverse effects in clinical trials were mild and transient.