REAL-WORLD EXPERIENCE OF ADMINISTERING PLERIXAFOR (MOZOBIL) FOR AUTOLOGOUS PERIPHERAL BLOOD STEM CELL HARVEST

Background & Aim From February 2017, the immunostimulant, plerixafor (Mozobil) became covered by insurance in Japan, and in the following month the drug was introduced into treatment for patients with haematological malignancies at Japanese Red Cross Medical Centre. The purpose of this retrospective study was to report experiences with administration of plerixafor for the mobilization and collection of hematopoietic stem cells, treatment outcomes and apheresis efficiency. Methods, Results & Conclusion Hospital records from patients undergoing peripheral blood stem cell harvest for autologous transplantation were reviewed between January 2016 and December 2018. A total of 134 patients (71 male, 63 female), aged from 19 to 69 years (mean age, 55.7 years) were collected. Of these, 89 patients (66.4%) were diagnosed with multiple myeloma, 24 patients (17.9%) with AL amyloidosis, 17 patients (12.7%) with non-Hodgkin's lymphoma, and 4 patients (3.0%) with other diseases. This cohort underwent 174 sessions of apheresis. Seventy-one of all patients (53.0%) were mobilized using plerixafor in combination with granulocyte-colony stimulating factor (G-CSF), while 63 patients (47.0%) were mobilized without plerixafor. Successful treatment outcome was defined as collecting ≥ 2.0 × 10 6 CD34+ cells per patient's body weight (/kg) following mobilization. In the plerixafor plus G-CSF treatment group, successful collection was observed in 64 of 71 patients (90.1%) and mobilization failure in 7 patients (9.9%). Of these, 55 patients (77.5%) were completed in one apheresis session. In the other group, without plerixafor, successful collection was observed in 50 of 63 patients (79.4%), and mobilization failure in 13 patients (20.6%). Of these, 44 patients (69.8%) were completed in one apheresis session. An increase in median CD34+ cells collected of 3.8 (1.0-11.9) × 10 6 /kg without plerixafor to 5.3 (0.5-16.7) × 10 6 /kg with plerixafor was observed. With the use of plerixafor, mobilization and collection of CD34+ cells was increased and the number of apheresis sessions required per patient showed a tendency to be reduced.