The Role of Plerixafor in the Management of Non-Hodgkin’s Lymphoma and Hematopoietic Stem Cell Transplantation
Autologous hematopoietic stem cell transplantation (HSCT) is an established treatment for relapsed chemotherapy sensitive non-Hodgkin’s lymphoma (NHL) and an important component of anti-myeloma therapy. Recovery of bone marrow function after autologous HSCT is dependant on the dose of infused hematopoietic stem cells (HSCs) after bone marrow ablation. Despite the use of chemotherapy and granulocyte colony-stimulating factor (G-CSF) based mobilization regimens, some patients are unable to mobilize adequate numbers of CD34+ HSCs and cannot undergo potentially lifesaving autologous HSCT. Plerixafor (AMD3100 or Mozobil) is a newly licensed drug which is used with G-CSF to mobilize CD34+ HSCs for autologous HSCT, reducing apheresis requirements, and the rate of primary mobilization failure. Plerixafor and G-CSF “rescue” protocols allow the successful mobilization of HSCs in patients that have failed standard G-CSF based mobilization protocols. Hematopoietic stem cell biology and the use of Plerixafor in the management of NHL are reviewed.
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