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.
Copyright © 2010 S. Karger AG, Basel.