UK consensus statement on the use of plerixafor to facilitate autologous peripheral blood stem cell collection to support high-dose chemoradiotherapy for patients with malignancy

作者：Douglas Kenneth W^*; Gilleece Maria; Hayden Patrick; Hunter Hannah; Johnson Peter R E; Kallmeyer Charlotte; Malladi Ram K; Paneesha Shankara; Pawson Rachel; Quinn Michael; Raj Kavita; Richardson Deborah; Robinson Stephen; Russell Nigel; Snowden John; Sureda Anna; Tholouli Eleni; Thomson Kirsty; Watts Mike; Wilson Keith M

来源：Journal of Clinical Apheresis, 2018, 33(1): 46-59.

DOI：10.1002/jca.21563

• autologous PBSC transplant
• consensus statement
• mobilization failure
• Peripheral blood stem cell mobilization
• plerixafor

Plerixafor is a CXC chemokine receptor (CXCR4) antagonist that mobilizes stem cells in the peripheral blood. It is indicated (in combination with granulocyte-colony stimulating factor [G-CSF]) to enhance the harvest of adequate quantities of cluster differentiation (CD) 34+ cells for autologous transplantation in patients with lymphoma or multiple myeloma whose cells mobilize poorly. Strategies for use include delayed re-mobilization after a failed mobilization attempt with G-CSF, and rescue or pre-emptive mobilization in patients in whom mobilization with G-CSF is likely to fail. Pre-emptive use has the advantage that it avoids the need to re-schedule the transplant procedure, with its attendant inconvenience, quality-of-life issues for the patient and cost of additional admissions to the transplant unit. UK experience from 2 major centers suggests that pre-emptive plerixafor is associated with an incremental drug cost of less than 2000 pound when averaged over all patients undergoing peripheral blood stem cell (PBSC) transplant. A CD34+ cell count of <15 mu l(-1) at the time of recovery after chemomobilization or after four days of G-CSF treatment, or an apheresis yield of <1 x 10(6) CD34+ cells/kg on the first day of apheresis, could be used to predict the need for pre-emptive plerixafor.

• 出版日期2018-2