Department of Hematology, Oncology and Clinical Immunology, University of Duesseldorf, Germany.
Acta Haematol. 2010;124(4):235-8. doi: 10.1159/000321509. Epub 2010 Nov 20.
Plerixafor is a reversible CXCR4 antagonist that leads to a rapid release of hematopoietic stem and progenitor cells (HPSCs) from the bone marrow into the peripheral blood by interfering with the CXCL12-CXCR4 interaction. Based on two multicenter phase III studies, plerixafor in combination with granulocyte colony-stimulating factor (G-CSF) was approved by the Food and Drug Administration for autologous HPSC mobilization in patients with multiple myeloma and non-Hodgkin's lymphoma. We report the case of a 26-year-old man with testicular cancer who was extensively pretreated and failed to mobilize a sufficient number of HPSCs after cytotoxic chemotherapy and the administration of G-CSF and pegylated G-CSF (PEG-G-CSF). Using a combination of plerixafor, G-CSF and PEG-G-GSF after chemotherapy, a sufficient number of HPSCs could be collected for the support of 3 sequential high-dose therapies. The patient achieved a complete and uncomplicated engraftment following each cycle of HPSC-supported high-dose therapy. Patients suffering from advanced germ cell cancer may be another group that benefits from the use of plerixafor, which to date has only been approved for the treatment of multiple myeloma and lymphoma. To our knowledge, this is the first case report of successful mobilization of HPSCs with plerixafor in a patient with testicular cancer.
plerixafor 是一种可逆的 CXCR4 拮抗剂，通过干扰 CXCL12-CXCR4 相互作用，导致造血干细胞和祖细胞（HPSCs）从骨髓迅速释放到外周血中。基于两项多中心 III 期研究，plerixafor 与粒细胞集落刺激因子（G-CSF）联合使用，经美国食品和药物管理局批准，用于多发性骨髓瘤和非霍奇金淋巴瘤患者的自体 HPSC 动员。我们报告了一例 26 岁男性睾丸癌患者的病例，该患者在细胞毒性化疗和 G-CSF 及聚乙二醇化 G-CSF（PEG-G-CSF）给药后广泛预处理，但未能动员足够数量的 HPSC。在化疗后使用 plerixafor、G-CSF 和 PEG-G-GSF 的组合，可以收集到足够数量的 HPSC 来支持 3 次序贯高剂量治疗。该患者在每轮 HPSC 支持的高剂量治疗后均实现了完全和无并发症的植入。患有晚期生殖细胞瘤的患者可能是另一个受益于 plerixafor 治疗的群体，迄今为止，plerixafor 仅被批准用于治疗多发性骨髓瘤和淋巴瘤。据我们所知，这是首例使用 plerixafor 成功动员 HPSC 的睾丸癌患者的病例报告。
