Plerixafor for Stem Cell Mobilization Prior to Autologous Stem Cell Transplant in Non-Hodgkin's Lymphoma and Multiple Myeloma

Abstract

Objective:

To review the pharmacology, pharmacokinetics, dosage, administration, clinical efficacy, safety, and place in therapy of plerixafor, a CXCR4 receptor antagonist used to mobilize stem cells prior to hematopoietic stem cell transplantation.

Data Sources:

Articles were identified by searching MEDLINE (1950-August 2009) and the American Society of Hematology abstract database using the key terms plerixafor, AMD3100, hematopoietic stem cell transplant, mobilization, multiple myeloma, and non-Hodgkin's lymphoma. Additional articles were obtained by using the reference sections of articles found during the literature search.

Study Selection and Data Extraction:

All articles identified from the literature search were reviewed for relevant information. Appropriate information was included in this review. The search was restricted to available English-language articles, including those on both preclinical and clinical trials.

Data Synthesis:

Plerixafor is a CXCR4 receptor antagonist approved by the FDA to assist in the mobilization of hematopoietic stem cells in patients with non-Hodgkin's lymphoma or multiple myeloma undergoing autologous stem cell transplant. Plerixafor is used in combination with granulocyte colony-stimulating factor. Plerixafor has been compared with placebo in both Phase 2 and Phase 3 clinical trials and has been shown to allow for a greater collection of hematopoietic stem cells in fewer apheresis sessions. Plerixafor demonstrated good tolerability in clinical trials.

Conclusions:

Plerixafor has demonstrated efficacy and tolerability when used for stem cell mobilization in patients with non-Hodgkin's lymphoma and multiple myeloma. Further studies are warranted to determine the safety and efficacy of plerixafor in patients with malignancies other than non-Hodgkin's lymphoma or multiple myeloma who are undergoing stem cell transplant and to determine its potential use in healthy stem cell donors.

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