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Blood, 1 September 2005, Vol. 106, No. 5, pp. 1867-1874.
Prepublished online as a Blood First Edition Paper on May 12, 2005; DOI 10.1182/blood-2005-02-0468.
 Previous Article | Next Article 
Submitted February 3, 2005
Accepted April 8, 2005
The Use of AMD3100 Plus G-CSF for Autologous Hematopoietic Progenitor Cell Mobilization is Superior to G-CSF Alone
Neal Flomenberg*, Steven M Devine, John F DiPersio, Jane L Liesveld, John M McCarty, Scott D Rowley, David H Vesole, Karin Badel, and Gary Calandra
Department of Medicine and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
Department of Medicine and Siteman Cancer Center, Washington University, St. Louis, MO, USA
Department of Medicine and James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA
Department of Medicine and Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
Adult Blood and Marrow Transplantation Program, Hackensack University Medical Center, Hackensack, NJ, USA
Medical College of Wisconsin, Milwaukee, WI, USA
AnorMED, Inc., Langley, BC, Canada
* Corresponding author; email: Neal.Flomenberg{at}mail.jci.tju.edu.
Hematopoietic progenitor cells (HPCs) traffic to and are retained in the marrow through the trophic effects of the chemokine SDF-1 binding to its receptor, CXCR4. AMD3100 reversibly inhibits SDF-1/CXCR4 binding, and AMD3100 administration mobilizes CD34+ cells into the circulation. We therefore tested the hypotheses that the combination of AMD3100 plus G-CSF (hereafter A+G) would be superior to G-CSF alone (hereafter G) in mobilizing HPCs and that A+G mobilized cells would engraft as well as G mobilized cells. The primary objective was to determine if patients mobilized more progenitor cells per unit blood volume of apheresis after A+G administration versus G alone. Secondary objectives were to determine if patients mobilized with A+G compared to G alone required fewer aphereses to reach the target level  5x106 CD34+ cells/kg for transplantation and to determine if patients mobilized with A+G had at least a 90% success rate of autologous transplantation as assessed by neutrophil engraftment by Day 21. Each patient served as his/her own control in a sequential mobilization design. All study objectives were met without significant toxicity. The results demonstrate that the combination of A+G is generally safe, effective, and superior to G alone for autologous HPC mobilization.
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