Use of plerixafor to mobilize haematopoietic progenitor cells in healthy donors.

Iñigo Romon, Carlos Castillo, Joan Cid, Miquel Lozano

Vox sanguinis 2022 Jan

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Increased transplant activity calls for improved stem cell collection, especially when peripheral blood is the preferred source of haematopoietic progenitor cells (HPCs). Plerixafor is a bicyclam molecule that mobilizes CD34+ cells by reversibly disrupting CXCR4-CXCL12-supported HPC retention. Plerixafor is given with granulocyte colony-stimulating factor (G-CSF) to help harvest autologous CD34+ cells for transplantation when mobilization with G-CSF fails. Mobilization protocols with the same doses of plerixafor and G-CSF have been used off-label in healthy allogeneic donors, with equal success and scarce side effects, both in adult and paediatric patients. Plerixafor has also been used as a sole mobilization agent. Plerixafor alone or coupled with G-CSF might lead to harvesting distinct cellular populations conferring improved engraftment properties and increased survival. Those characteristics might make plerixafor an especially attractive mobilization agent, particularly for non-related donations. However, available data are limited, and long-term follow-up is needed to clarify the best scenario for using plerixafor with or without G-CSF in healthy donors. In this review, we will summarize the evidence supporting this practice, highlighting the practical aspects and providing clues for an expanded use of plerixafor. © 2021 International Society of Blood Transfusion.

Citation

Iñigo Romon, Carlos Castillo, Joan Cid, Miquel Lozano. Use of plerixafor to mobilize haematopoietic progenitor cells in healthy donors. Vox sanguinis. 2022 Jan;117(1):6-16