Plerixafor ‘on demand’: results of a strategy based on peripheral blood CD34+ cells in lymphoma patients at first or subsequent mobilization with chemotherapy+G-CSF

Farina, Lucia; Guidetti, Anna; Spina, Francesco; Roncari, Luisa; Longoni, Paolo; Ravagnani, Fernando; Carlo‐Stella, Carmelo; Corradini, Paolo

doi:10.1038/bmt.2013.193

Cited by 9 publications

(10 citation statements)

References 16 publications

(19 reference statements)

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“…Table shows that less than half of patients received plerixafor after failing a prior mobilization and/or collection attempt, as part of a remobilization treatment. Conversely, more than half of patients were given plerixafor as part of their first HSPC mobilization attempt at collection, using a so‐called “pre‐emptive” or on‐demand approach: the goal is to convert an unfavorable situation into a more favorable one by the immediate introduction of plerixafor in addition to already prescribed G‐CSF, with no further delay and no need for re‐mobilization at a later time point. Fifty‐nine patients (or 26.2%) of the 225 patients for whom a measure of circulating CD34+ cells was available before introduction of plerixafor, had undergone an apheresis procedure, before the introduction of plerixafor.…”

Section: Resultsmentioning

confidence: 99%

“…22,23 Multiple studies have demonstrated the ability of plerixafor to rescue poor mobilizers who had failed previous mobilization and collection attempts with various types of mobilization regimens. [24][25][26][27][28][29][30][31][32][33] The European Medicines Agency granted a marketing authorization for plerixafor in 2009, restricting its administration to poor mobilizers but using an unusual terminology that refers to patients ". .…”

Section: Results and Conclusionmentioning

confidence: 99%

“…Additional studies have confirmed the efficacy of plerixafor in first‐line mobilization regimen in patients with lymphoid malignancies, including Hodgkin's disease . Multiple studies have demonstrated the ability of plerixafor to rescue poor mobilizers who had failed previous mobilization and collection attempts with various types of mobilization regimens . The European Medicines Agency granted a marketing authorization for plerixafor in 2009, restricting its administration to poor mobilizers but using an unusual terminology that refers to patients “… who mobilize poorly ….” Given the above‐described variations in the definition of poor mobilizers, regulatory authorities in France (the Direction Générale de la Santé, the Haute Autorité de Santé, and the Comité Economique des Produits de Santé) commissioned a postmarketing authorization survey, to evaluate actual conditions for the use of plerixafor in France.…”

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confidence: 99%

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A nationwide survey of the use of plerixafor in patients with lymphoid malignancies who mobilize poorly demonstrates the predominant use of the “on‐demand” scheme of administration at French autologous hematopoietic stem cell transplant programs

et al. 2015

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We report here the results of this nationwide survey that confirms the clinical efficacy of plerixafor, even in the subset of patients who barely increased PB CD34+ cell count in response to rHuG-CSF-containing mobilization regimen. Furthermore, analysis of this registry showed that despite heterogeneity in medical practices, the early-"on-demand" or "preemptive"-introduction of plerixafor was widely used and did not result in an excess of prescriptions, beyond its expected use at the time when marketing authorization was granted.

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Section: Resultsmentioning

confidence: 99%

Section: Results and Conclusionmentioning

confidence: 99%

mentioning

confidence: 99%

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A nationwide survey of the use of plerixafor in patients with lymphoid malignancies who mobilize poorly demonstrates the predominant use of the “on‐demand” scheme of administration at French autologous hematopoietic stem cell transplant programs

et al. 2015

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“…Despite developments in SCM protocols, a proportion of patients between 5 and 30% fail to collect an adequate number of CD34+ [3][4][5][6][7]. Poor mobilization forces the patient to undergo a re-mobilization procedure and in some cases leads to postponing or even abandoning a transplant strategy.…”

Section: Introductionmentioning

confidence: 99%

Predicting failure of hematopoietic stem cell mobilization before it starts: the predicted poor mobilizer (pPM) score

Olivieri

Attolico²,

Nuccorini³

et al. 2018

Bone Marrow Transplant

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Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p < 0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure.

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“…42 However, using G-CSF alone is cheaper, more convenient and associated with fewer adverse effects than chemotherapy plus G-CSF. 36,[43][44][45][46] The benefits and limitations of adding chemotherapy are summarised in Table 1. A 1997 study (n=40) found that chemotherapy plus G-CSF was not superior to G-CSF alone in terms of HSC yields.…”

mentioning

confidence: 99%

How to Find the Optimal Mobilisation Strategy – Impact, Challenges and Solutions

Wuchter¹,

Hübel²

2016

European Oncology &Amp; Haematology

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A utologous haematopoietic stem-cell transplantation (HSCT) is the standard treatment for a number of haematological malignancies. Achieving sufficient haematopoietic stem cell mobilisation is a prerequisite, but exactly how to define and achieve this goal remains a subject of debate. Key questions include which pharmacological agents to use, timing of treatments and mobilisation, and, in particular, target numbers of stem cells. Clinicians from Europe, North America and Asia compared their experiences and discussed these issues at a satellite workshop during the 3rd International Congress on Controversies in Stem Cell Transplantation and Cellular Therapies (COSTEM 2015). This review discusses the challenges of optimising leukapheresis in the context of these discussions. Although several studies suggest that the cell dose influences transplant outcomes in HSCT, other studies have not reached this conclusion. Recent data indicate that the graft composition also plays a role. More prospective study data are needed for a fuller understanding of engraftment outcomes using different mobilisation protocols.

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Plerixafor ‘on demand’: results of a strategy based on peripheral blood CD34+ cells in lymphoma patients at first or subsequent mobilization with chemotherapy+G-CSF

Cited by 9 publications

References 16 publications

A nationwide survey of the use of plerixafor in patients with lymphoid malignancies who mobilize poorly demonstrates the predominant use of the “on‐demand” scheme of administration at French autologous hematopoietic stem cell transplant programs

A nationwide survey of the use of plerixafor in patients with lymphoid malignancies who mobilize poorly demonstrates the predominant use of the “on‐demand” scheme of administration at French autologous hematopoietic stem cell transplant programs

Predicting failure of hematopoietic stem cell mobilization before it starts: the predicted poor mobilizer (pPM) score

How to Find the Optimal Mobilisation Strategy – Impact, Challenges and Solutions

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