Mobilizace krvetvorných buněk pomocí plerixaforz-zkušenosti transplantačních center v České republice

KOŘÍSTEK, Zdeněk, D. POHLREICH, D. LYSÁK, M. LÁNSKÁ, J. NOVÁK, Tomáš KEPÁK, Ivana SKOUMALOVÁ and Jan MUŽÍK. Mobilizace krvetvorných buněk pomocí plerixaforz-zkušenosti transplantačních center v České republice (Mobilization of hematopoetic stem cells using plerixafor - Experience of the Czech Republic transplantation centers). Transfuze a hematologie dnes. Česká lékařská společnost J. E. Purkyně, 2012, vol. 18, No 1, p. 6-12. ISSN 1213-5763.

Basic information

Original name

Mobilizace krvetvorných buněk pomocí plerixaforz-zkušenosti transplantačních center v České republice

Name (in English)

Mobilization of hematopoetic stem cells using plerixafor - Experience of the Czech Republic transplantation centers

Authors

KOŘÍSTEK, Zdeněk (203 Czech Republic, guarantor, belonging to the institution), D. POHLREICH (203 Czech Republic), D. LYSÁK (203 Czech Republic), M. LÁNSKÁ (203 Czech Republic), J. NOVÁK (203 Czech Republic), Tomáš KEPÁK (203 Czech Republic, belonging to the institution), Ivana SKOUMALOVÁ (203 Czech Republic) and Jan MUŽÍK (203 Czech Republic, belonging to the institution)

Edition

Transfuze a hematologie dnes, Česká lékařská společnost J. E. Purkyně, 2012, 1213-5763

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Other information

Language

Czech

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/12:00063162

Organization unit

Faculty of Medicine

Keywords (in Czech)

plerixafor; mobilizace; PBSC; CD34plus buňky; poor mobilizer; autologní transplantace krvetvorby

Keywords in English

Autologous hematopoietic transplantation; CD34plus cells; Mobilization; PBSC; Plerixafor; Poor mobilizer

Tags

Reviewed

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Abstract

V originále

Plerixafor je novým typem léku, jehož podání vede nezávisle na chemoterapii a na G-CSF k vyplavení progenitorů krvetvorby (HSC) do periferní krve. Plerixafor je derivát bicyklamu o malé molekule, který reverzibilně blokuje vazbu SDF-1/CXCR4. Tato vazba patří mezi nejdůležitější mechanismy, které udržují HSC v prostředí kostní dřeně a její inhibice vede k rychlé mobilizaci HSC do krve. Plerixafor je velmi cenným lékem zejména pro skupinu pacientů, u kterých standardní mobilizace (G-CSF chemoterapie) nevede k dostatečnému vyplavení HSC do krve a u kterých tak nelze získat bezpečný štěp periferních kmenových buněk (PBSC, peripheral blood stem cells) pro autologní transplantaci. Cílem této retrospektivní studie je vyhodnotit výsledky dosažené při podávání plerixaforu v transplantačních centrech České republiky.

In English

Plerixafor is a novel kind of drug which administration leads to a hematopoietic stem and progenitor cells (HSC) mobilization independently of chemotherapy or G-CSF. Plerixafor is a small molecule bicyclam derivate and inhibits reversibly the SDF-1/CXCR4 interaction, which belongs to the most important mechanisms binding HSC to the bone marrow microenvironment. Inhibition of SDF-1/CXCR4 interaction results in a fast mobilization of HSC into a peripheral blood. Plerixafor is a very valuable substance especially for patients who are not able to mobilize sufficient numbers of HSC after G-CSF chemotherapy and, therefore, who are not the candidates for autologous peripheral blood stem cells (PBSC) transplantation because they are not able to collect adequate transplants. The aim of this study is to evaluate results reached with plerixafor in transplant centres in Czech Republic. Patients and methods: Plerixafor was given between 2/2009 and 8/2011 to 93 patients of age from 4 months to 71 years (63% males, 37% females), who were assessed to be proven (failed previous or current mobilization attempt; 82%) or predicted (high risk of failed mobilization; 13.5%) poor mobilizers. Results: The primary objective to collect a safe transplant was reached in 71.6% of mobilizations. Plerixafor adverse events were mild and well tolerated. Overall, 66 patients (71.0%) were treated by 69 transplantations using collected PBSC, engraftment was fast and durable. Conclusion: We conclude that plerixafor is a very efficient mobilization agent which allows collecting safe PBSC transplants of a good quality without significant adverse events in a majority of patients who failed standard mobilization. Plerixafor administration enables these patients to proceed to high dose therapy with autologous transplantation, which could significantly improve their prognosis or have a curative effect in certain patients.