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Abstract：
Plerixafor is a CXC chemokine receptor (CXCR4) antagonist that mobilizes stem cells in the peripheral blood. It is indicated (in combination with granulocyte-colony stimulating factor [G-CSF]) to enhance the harvest of adequate quantities of cluster differentiation (CD) 34+ cells for autologous transplantation in patients with lymphoma or multiple myeloma whose cells mobilize poorly. Strategies for use include delayed re-mobilization after a failed mobilization attempt with G-CSF, and rescue or pre-emptive mobilization in patients in whom mobilization with G-CSF is likely to fail. Pre-emptive use has the advantage that it avoids the need to re-schedule the transplant procedure, with its attendant inconvenience, quality-of-life issues for the patient and cost of additional admissions to the transplant unit. UK experience from 2 major centers suggests that pre-emptive plerixafor is associated with an incremental drug cost of less than £2000 when averaged over all patients undergoing peripheral blood stem cell (PBSC) transplant. A CD34+ cell count of <15 µl-1 at the time of recovery after chemomobilization or after four days of G-CSF treatment, or an apheresis yield of <1 × 106 CD34+ cells/kg on the first day of apheresis, could be used to predict the need for pre-emptive plerixafor.
摘要：
Plerixafor是一种CXC趋化因子受体（CXCR4）拮抗剂，可动员外周血中的干细胞。表明（与粒细胞集落刺激因子[G-CSF]结合使用）可增强淋巴瘤或多发性骨髓瘤患者自体移植的足够数量的簇分化（CD）34细胞的收获，这些细胞的动员能力较差。使用策略包括在G-CSF动员尝试失败后延迟重新动员，以及G-CSF动员可能失败的患者的抢救或抢先动员。先发制人使用的优点是它避免了重新安排移植程序的需要，伴随着它的不便，患者的生活质量问题和移植单位额外入院的费用。来自两个主要中心的英国经验表明，在所有接受外周血干细胞（PBSC）移植的患者中，先发制人的药物成本平均低于2000英镑。一个CD34+细胞计数<15μl-1在恢复后的时候，或在4天的G-CSF治疗，或单采第一天的单采率<1×106CD34+细胞/kg，可用于预测先发制人的需求。
