Valeria Alejandra Bernardo1, John Szechung Ng2, Michael John Joyce3. 1. Valeria Alejandra Bernardo PharmD, Clinical Pharmacy Resident, St. Jude Children's Research Hospital, Memphis, TN vabernardo@hotmail.com. 2. John Szechung Ng PharmD, Pediatric Clinical Pharmacist, Hematology, Oncology, Stem Cell Transplant, Wolfson Children's Hospital/Baptist Medical Center, Jacksonville, FL. 3. Michael John Joyce MD PhD, Program Director of Pediatric Blood and Marrow Transplantation, Division of Hematology, Oncology, Nemours Children's Clinic, Jacksonville.
Abstract
OBJECTIVE: To present a case where plerixafor was successfully used in combination with granulocyte colony-stimulating factor (G-CSF) for mobilization of hematopoietic stem cells in a pediatric patient. CASE SUMMARY: An 11-year-old boy with recurrent anaplastic large-cell lymphoma failed to yield an adequate number of CD34+ cells with G-CSF for mobilization. After a single subcutaneous dose of plerixafor 240 μg/kg was administered in addition to filgrastim, sufficient CD34+ cells were harvested for transplantation. A local injection site reaction was the only adverse reaction reported. DISCUSSION: Several studies in adults have shown plerixafor to be effective for the mobilization of hematopoietic stem cells when used in combination with G-CSF in adults with non-Hodgkin's lymphoma and multiple myeloma who failed to mobilize sufficient CD34+ cells with G-CSF alone. There is limited information regarding the safety and efficacy of plerixafor in pediatric patients. CONCLUSIONS: Plerixafor was effective in increasing the number of hematopoietic stem cells in the peripheral blood of an 11-year-old patient; studies are needed to evaluate the safety and effectiveness of plerixafor in pediatric patients.
OBJECTIVE: To present a case where plerixafor was successfully used in combination with granulocyte colony-stimulating factor (G-CSF) for mobilization of hematopoietic stem cells in a pediatric patient. CASE SUMMARY: An 11-year-old boy with recurrent anaplastic large-cell lymphoma failed to yield an adequate number of CD34+ cells with G-CSF for mobilization. After a single subcutaneous dose of plerixafor 240 μg/kg was administered in addition to filgrastim, sufficient CD34+ cells were harvested for transplantation. A local injection site reaction was the only adverse reaction reported. DISCUSSION: Several studies in adults have shown plerixafor to be effective for the mobilization of hematopoietic stem cells when used in combination with G-CSF in adults with non-Hodgkin's lymphoma and multiple myeloma who failed to mobilize sufficient CD34+ cells with G-CSF alone. There is limited information regarding the safety and efficacy of plerixafor in pediatric patients. CONCLUSIONS:Plerixafor was effective in increasing the number of hematopoietic stem cells in the peripheral blood of an 11-year-old patient; studies are needed to evaluate the safety and effectiveness of plerixafor in pediatric patients.