Up to 10% of germ cell tumour patients require salvage high-dose chemotherapy with stem cell support, achieving cure rates in the range of 10-60%. Stem cell mobilisation may be difficult in these patients because of multiple lines of treatment known to seriously hamper stem cell recovery. Plerixafor significantly enhances the success of the CD34+ cell harvest, even in cases where prior mobilisation attempts have failed. Six germ cell tumour patients provided informed consent and were included in the compassionate use program. All patients were heavily pretreated, with a median of 3.5 prior lines of therapy. All failed prior mobilisation with G-CSF in combination with chemotherapy. Five patients yielded a median of 2.6 x 106 CD34+ cells per kg body weight in a median of 4 apheresis days when plerixafor was used. Three patients underwent subsequent high-dose chemotherapy with autologous stem cell support. Median time to leukocyte engraftment was 11 days. Median time to platelet engraftment was 12.5 days, both of which are comparable to previous historical data. Accordingly, plerixafor seems to be safe and effective in germ cell tumour patients who have failed prior mobilisation therapy. Larger prospective studies are warranted to further assess its use in germ cell cancer.
Authors: Kobold, S.; Isernhagen, J.; Huebel, K.; Kilic, N.; Bogner, C.; Frickhofen, N.; Bokemeyer, C.; Fiedler, W. ;Full Source: Bone Marrow Transplantation [online computer file] 2011, 46(8), 1053-1056 (Eng) ;