Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.
Skip to main content

BACKGROUND: Rarely, healthy donors fail adequate peripheral blood stem cell (PBSC) mobilization. If the recipient has already received conditioning chemotherapy, this can result in the donor undergoing urgent marrow harvest under general anesthesia. Plerixafor is a novel CXCR4 antagonist, licensed for autologous PBSC harvest (PBSCH) in patients who failed mobilization with granulocyte-colony-stimulating factor (G-CSF) alone. Experience using plerixafor in healthy allogeneic donors failing G-CSF mobilization is scarce. CASE REPORT: A 65-year-old patient was referred for a reduced-intensity conditioning sibling allograft for relapsed follicular lymphoma. She received fludarabine, melphalan, and alemtuzumab conditioning. Her 68-year-old brother was fully HLA matched. PBSCH was planned on Day -1 after 4 days of 10 μg/kg G-CSF. Day 1 PBSCH collected an inadequate number of CD34+ 0.35 × 10(6) /kg cells. Despite increasing G-CSF (16 μg/kg), Day 2 yielded 0.33 × 10(6) /kg CD34+ cells, giving a suboptimal total dose. He proceeded to a third PBSCH day after plerixafor (0.24 mg/kg) and G-CSF (16 μg/kg) were given the evening before. A total of 1.79 × 10(6) /kg CD34+ cells were harvested, giving a total dose of 2.46 × 10(6) /kg CD34+ cells. After initial neutrophil engraftment on Day +13, the patient's neutrophils gradually decreased to 0.02 × 10(9) /L by Day +74. A marrow aspirate on Day +81 was markedly hypocellular. Total white blood cell chimerism was near 100% donor on Days +32, +74, and +102. Despite chimeric-only engraftment, the patient remains platelet and red blood cell transfusion dependent. CONCLUSION: Rescue plerixafor to assist PBSCH in healthy allogeneic donors has been effective in terms of CD34+ cell number mobilized. It is unclear whether the partial engraftment seen was coincidental or related to a difference in PBSC quality.

Original publication




Journal article



Publication Date





1231 - 1234


Aged, Blood Donors, Female, Granulocyte Colony-Stimulating Factor, Hematopoietic Stem Cell Mobilization, Hematopoietic Stem Cell Transplantation, Heterocyclic Compounds, Humans, Male, Receptors, CXCR4, Siblings