Abstract

Background: In recent years, plerixafor, a CXCR4 chemokine receptor inhibitor, has emerged as a promising agent for the mobilization of hematopoietic stem cells (HSCs) when combined with other mobilizers such as granulocyte colony-stimulating factor (G-CSF) and chemotherapy in patients with multiple myeloma and lymphoma undergoing autologous peripheral blood stem cell transplantation (APBSCT). Our facility has recently implemented plerixafor as a specialized rescue treatment in lymphoma patients who are at risk or have experienced mobilization failure with G-CSF.

Case Series: We present five cases of lymphoma in young adult patients (26 to 49 years old), comprising two cases of Hodgkin lymphoma and three cases of diffuse large B-cell lymphoma. All five patients presented with advanced stage IV disease. Three patients received plerixafor following initial mobilization failure with G-CSF-based protocols, one patient received plerixafor preemptively, and one patient received it as an upfront treatment strategy.

Outcomes: All five cases achieved a collection of CD34⁺ cells exceeding 2 × 10⁶ cells/kg (ranging from 2.67 to 3.95 × 10⁶ cells/kg) after a single mobilization involving plerixafor, and no adverse reactions were reported.

Conclusion: Our findings highlight the significant enhancement of HSCs mobilization achieved with plerixafor compared to traditional methods. Plerixafor is not only highly effective but also safe for use in lymphoma patients. These case series findings underscore its value as a key tool in optimizing HSCs collection for successful APBSCT.