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Hopman RK, DiPersio JF. Advances in stem cell mobilization. Blood Rev 2014; 28:31-40. [PMID: 24476957 DOI: 10.1016/j.blre.2014.01.001] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 12/23/2013] [Accepted: 01/06/2014] [Indexed: 12/22/2022]
Abstract
Use of granulocyte colony stimulating factor (G-CSF)-mobilized peripheral blood hematopoietic progenitor cells (HPCs) has largely replaced bone marrow (BM) as a source of stem cells for both autologous and allogeneic cell transplantation. With G-CSF alone, up to 35% of patients are unable to mobilize sufficient numbers of CD34 cells/kg to ensure successful and consistent multi-lineage engraftment and sustained hematopoietic recovery. To this end, research is ongoing to identify new agents or combinations which will lead to the most effective and efficient stem cell mobilization strategies, especially in those patients who are at risk for mobilization failure. We describe both established agents and novel strategies at various stages of development. The latter include but are not limited to drugs that target the SDF-1/CXCR4 axis, S1P agonists, VCAM/VLA-4 inhibitors, parathyroid hormone, proteosome inhibitors, Groβ, and agents that stabilize HIF. While none of the novel agents have yet gained an established role in HPC mobilization in clinical practice, many early studies exploring these new pathways show promising results and warrant further investigation.
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Affiliation(s)
- Rusudan K Hopman
- Division of Oncology, Washington University School of Medicine, USA
| | - John F DiPersio
- Division of Oncology, Washington University School of Medicine, USA; Siteman Cancer Center, Washington University School of Medicine, USA.
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Gunzer M. Traps and hyper inflammation - new ways that neutrophils promote or hinder survival. Br J Haematol 2013; 164:189-99. [PMID: 24138538 DOI: 10.1111/bjh.12608] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 09/11/2013] [Indexed: 01/13/2023]
Abstract
For a long time neutrophil granulocytes were considered simply as terminally differentiated cells with a limited life span and pathogen killing by phagocytosis and chemical toxicity being the sole mode of action. However, work during the last 10 years has started to change this view fundamentally. Modern understanding is that neutrophils have an enormous complexity of functions. This review discusses very recent findings on how neutrophils can control the spread of pathogens and mediate their killing by mechanisms such as formation of DNA nets, how they influence tumour growth and adaptive immune responses and how they manoeuvre inside the diverse compartments of the body. It will also describe how the normally protective functions of neutrophils can have deleterious consequences if they occur in an uncontrolled fashion. These exciting novel findings are likely to completely and permanently change our view of this central leucocyte population.
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Affiliation(s)
- Matthias Gunzer
- Institute for Experimental Immunology and Imaging, University Duisburg-Essen, University Hospital, Essen, Germany
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53
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Shi PA, Miller LK, Isola LM. Prospective study of mobilization kinetics up to 18 hours after late-afternoon dosing of plerixafor. Transfusion 2013; 54:1263-8. [PMID: 24128272 DOI: 10.1111/trf.12459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 08/29/2013] [Accepted: 09/05/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND The current FDA-approved time interval between plerixafor dosing and apheresis initiation is approximately 11 hours, but this time interval is impractical for most care providers. Few studies have examined mobilization kinetics beyond 11 hours in multiple myeloma (MM) and non-Hodgkin's lymphoma (NHL) patients. Therefore, this study's intent was to analyze an interval of 17 to 18 hours between plerixafor dosing and apheresis initiation. STUDY DESIGN AND METHODS In 11 patients with MM or NHL, 240 μg/kg plerixafor was administered at 5 p.m. on Day 4 of granulocyte-colony-stimulating factor (G-CSF) mobilization. Peripheral blood (PB) CD34+ and CD34+CD38- concentrations were enumerated every 2 hours until 7 a.m. and immediately before apheresis on Day 5, for a total interval time of 17 to 18 hours after plerixafor. Data were analyzed using mixed-model analysis of repeated measures and paired t testing. RESULTS Ten of the 11 subjects achieved a CD34+ product count of more than 2 × 10(6) /kg with a single leukapheresis procedure. All 10 had a preplerixafor PB CD34+ concentration ([CD34+]) of at least 10/μL. PB [CD34+] was not different between 10 and 18 hours after plerixafor (p = 0.8). In contrast, PB CD34+CD38- concentrations significantly increased from 10 to 18 hours after plerixafor (p = 0.03). CONCLUSIONS In MM and NHL patients with adequate preplerixafor [CD34+], leukapheresis initiated 14 to 18 hours after plerixafor and G-CSF mobilization may not impair adequate CD34+ collection and may increase more primitive CD34+CD38- collection. In this subset of patients, late-afternoon dosing of plerixafor at 5 p.m. with initiation of next-day apheresis as late as 11 a.m. appears feasible without loss of efficacy.
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Affiliation(s)
- Patricia A Shi
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York
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Liao YX, Zhou CH, Zeng H, Zuo DQ, Wang ZY, Yin F, Hua YQ, Cai ZD. The role of the CXCL12-CXCR4/CXCR7 axis in the progression and metastasis of bone sarcomas (Review). Int J Mol Med 2013; 32:1239-46. [PMID: 24127013 DOI: 10.3892/ijmm.2013.1521] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/25/2013] [Indexed: 11/06/2022] Open
Abstract
Bone sarcomas, which comprise less than 1% of all human malignancies, are a group of relatively rare mesenchymal-derived tumors. They are mainly composed of osteosarcoma, chondrosarcoma and Ewing's sarcoma. In spite of advances in adjuvant chemotherapy and wide surgical resection, prognosis remains poor due to the high propensity for lung metastasis, which is the leading cause of mortality in patients with bone sarcomas. Chemokines are a superfamily of small pro-inflammatory chemoattractant cytokines which can bind to specific G protein-coupled seven-span transmembrane receptors. Chemokine 12 (CXCL12), also designated as stromal cell-derived factor-1 (SDF-1), is able to bind to its cognate receptors, chemokine receptor 4 (CXCR4) and chemokine receptor 7 (CXCR7), with high affinity. The binding of CXCL12 to CXCR4/CXCR7 stimulates the activation of several downstream signaling pathways that regulate tumor progression and metastasis. In this review, the structure and function of CXCL12 and its receptors, CXCR4 and CXCR7, as well as many factors affecting their expression are discussed. Phosphoinositide 3-kinase (PI3K) and mitogen-activated protein kinase (MAPK) pathways are the two most important downstream pathways regulated by the CXCL12-CXCR4/CXCR7 interaction. CXCR4 expression in bone sarcomas, including tumor cells and samples and the correlation between CXCR4/CXCR7 expression and the survival of patients with bone sarcomas are also discussed. In addition, we review the involvement of the CXCL12‑CXCR4/CXCR7 axis in the growth and metastasis of bone sarcomas and the targeting of this axis in preclinical studies.
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Affiliation(s)
- Yu-Xin Liao
- Shanghai Bone Cancer Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Alvarez P, Carrillo E, Vélez C, Hita-Contreras F, Martínez-Amat A, Rodríguez-Serrano F, Boulaiz H, Ortiz R, Melguizo C, Prados J, Aránega A. Regulatory systems in bone marrow for hematopoietic stem/progenitor cells mobilization and homing. BIOMED RESEARCH INTERNATIONAL 2013; 2013:312656. [PMID: 23844360 PMCID: PMC3703413 DOI: 10.1155/2013/312656] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/22/2013] [Accepted: 05/24/2013] [Indexed: 12/14/2022]
Abstract
Regulation of hematopoietic stem cell release, migration, and homing from the bone marrow (BM) and of the mobilization pathway involves a complex interaction among adhesion molecules, cytokines, proteolytic enzymes, stromal cells, and hematopoietic cells. The identification of new mechanisms that regulate the trafficking of hematopoietic stem/progenitor cells (HSPCs) cells has important implications, not only for hematopoietic transplantation but also for cell therapies in regenerative medicine for patients with acute myocardial infarction, spinal cord injury, and stroke, among others. This paper reviews the regulation mechanisms underlying the homing and mobilization of BM hematopoietic stem/progenitor cells, investigating the following issues: (a) the role of different factors, such as stromal cell derived factor-1 (SDF-1), granulocyte colony-stimulating factor (G-CSF), and vascular cell adhesion molecule-1 (VCAM-1), among other ligands; (b) the stem cell count in peripheral blood and BM and influential factors; (c) the therapeutic utilization of this phenomenon in lesions in different tissues, examining the agents involved in HSPCs mobilization, such as the different forms of G-CSF, plerixafor, and natalizumab; and (d) the effects of this mobilization on BM-derived stem/progenitor cells in clinical trials of patients with different diseases.
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Affiliation(s)
- P. Alvarez
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - E. Carrillo
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - C. Vélez
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - F. Hita-Contreras
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - A. Martínez-Amat
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - F. Rodríguez-Serrano
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - H. Boulaiz
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - R. Ortiz
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - C. Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - J. Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - A. Aránega
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
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Yuan S, Nademanee A, Krishnan A, Kogut N, Shayani S, Wang S. Second time a charm? Remobilization of peripheral blood stem cells with plerixafor in patients who previously mobilized poorly despite using plerixafor as a salvage agent. Transfusion 2013; 53:3244-50. [PMID: 23607889 DOI: 10.1111/trf.12198] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/08/2013] [Accepted: 02/12/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Plerixafor is a recently introduced agent used to improve peripheral blood stem cell (PBSC) mobilization in patients with hematologic malignancies. However, some patients still cannot mobilize adequately even with plerixafor. STUDY DESIGN AND METHODS We retrospectively reviewed the PBSC collections of 18 consecutive lymphoma and multiple myeloma patients, who had previously mobilized poorly despite the use of plerixafor and received plerixafor again during remobilization. RESULTS During the first mobilization attempt, all 18 recombinant granulocyte-colony-stimulating factor (G-CSF; two) or G-CSF plus chemotherapy-mobilized patients (16) had poor response to plerixafor, with peripheral blood (PB) CD34+ counts ranging from 0 to 7.48 × 10(6)/L after the first dose. They collected only 0.15 × 10(6) to 1.63 × 10(6) (median, 0.40 × 10(6)) CD34+ cells/kg after one to four collections. The median average daily yield was 0.24 × 10(6) CD34+ cells/kg. Remobilization began 1 to 4 weeks later with G-CSF, plerixafor, and with (three) or without (15) cyclophosphamide. The PB CD34+ cell counts after the first dose of plerixafor were 3.04 × 10(6) to 127.54 × 10(6)/L (median, 14.58 × 10(6)/L). After one to four doses of plerixafor, each patient collected an additional 0.39 × 10(6) to 14.02 × 10(6) (median, 1.89 × 10(6)) CD34+ cells/kg, and the median daily average was 0.78 × 10(6) CD34+ cells/kg. Cumulatively, after two rounds of collections, 15 collected more than 2.0 × 10(6) CD34+ cells/kg. Thirteen have proceeded to autologous stem cell transplantation (ASCT) and successfully engrafted. CONCLUSION In patients who had responded poorly to the use of plerixafor as a mobilization salvage agent, response to remobilization with plerixafor for the second time was variable, but most (83.3%) patients were able to collect enough PBSCs to proceed to ASCT.
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Affiliation(s)
- Shan Yuan
- Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, Department of Hematology, Department of Pharmacy, City of Hope National Medical Center, Duarte, California
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Chang CLT, Lin Y, Bartolome AP, Chen YC, Chiu SC, Yang WC. Herbal therapies for type 2 diabetes mellitus: chemistry, biology, and potential application of selected plants and compounds. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:378657. [PMID: 23662132 PMCID: PMC3638592 DOI: 10.1155/2013/378657] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 03/11/2013] [Indexed: 01/07/2023]
Abstract
Diabetes mellitus has been recognized since antiquity. It currently affects as many as 285 million people worldwide and results in heavy personal and national economic burdens. Considerable progress has been made in orthodox antidiabetic drugs. However, new remedies are still in great demand because of the limited efficacy and undesirable side effects of current orthodox drugs. Nature is an extraordinary source of antidiabetic medicines. To date, more than 1200 flowering plants have been claimed to have antidiabetic properties. Among them, one-third have been scientifically studied and documented in around 460 publications. In this review, we select and discuss blood glucose-lowering medicinal herbs that have the ability to modulate one or more of the pathways that regulate insulin resistance, β-cell function, GLP-1 homeostasis, and glucose (re)absorption. Emphasis is placed on phytochemistry, anti-diabetic bioactivities, and likely mechanism(s). Recent progress in the understanding of the biological actions, mechanisms, and therapeutic potential of compounds and extracts of plant origin in type 2 diabetes is summarized. This review provides a source of up-to-date information for further basic and clinical research into herbal therapy for type 2 diabetes. Emerging views on therapeutic strategies for type 2 diabetes are also discussed.
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Affiliation(s)
- Cicero L. T. Chang
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Yenshou Lin
- Department of Life Science, National Taiwan Normal University, Taipei 116, Taiwan
| | - Arlene P. Bartolome
- Institute of Chemistry, University of the Philippines, Diliman, Quezon City 1100, Philippines
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Academia Sinica Road, Section 2, Nankang, Taipei 115, Taiwan
| | - Yi-Ching Chen
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Academia Sinica Road, Section 2, Nankang, Taipei 115, Taiwan
| | - Shao-Chih Chiu
- Graduate Institute of Immunology, China Medical University, Taichung 404, Taiwan
- Center for Neuropsychiatry, China Medical University Hospital, Taichung 404, Taiwan
| | - Wen-Chin Yang
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Academia Sinica Road, Section 2, Nankang, Taipei 115, Taiwan
- Institute of Pharmacology, Yang-Ming University, Taipei 112, Taiwan
- Institute of Zoology, National Taiwan University, Taipei 106, Taiwan
- Department of Life Sciences, National Chung Hsing University, Taichung 402, Taiwan
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58
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Chang CLT, Lin Y, Bartolome AP, Chen YC, Chiu SC, Yang WC. Herbal therapies for type 2 diabetes mellitus: chemistry, biology, and potential application of selected plants and compounds. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 5:22-9. [PMID: 23598921 PMCID: PMC3579016 DOI: 10.4103/0974-8490.105644] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 05/02/2012] [Accepted: 01/08/2013] [Indexed: 01/11/2023]
Abstract
Background: Diabetes mellitus, becoming the third killer of mankind after cancer and cardiovascular diseases, is one of the most challenging diseases facing health care professionals today. That is why; there has been a growing interest in the therapeutic use of natural products for diabetes, especially those derived from plants. Aim: To evaluate the anti-diabetic activity together with the accompanying biological effects of the fractions and the new natural compounds of Hyphaene thebaica (HT) epicarp. Materials and Methods: 500 g of coarsely powdered of (HT) fruits epicarp were extracted by acetone. The acetone crude extract was fractionated with methanol and ethyl acetate leaving a residual water-soluble fraction WF. The anti-diabetic effects of the WF and one of its compounds of the acetone extract of the (HT) epicarp were investigated in this study using 40 adult male rats. Results: Phytochemical investigation of active WF revealed the presence of ten different flavonoids, among which two new natural compounds luteolin 7-O-[6”-O-α-Lrhamnopyranosyl]-β-D-galactopyranoside 3 and chrysoeriol 7-O-β-D-galactopyranosyl(1→2)-α-L-arabinofuranoside 5 were isolated. Supplementation of the WF improved glucose and insulin tolerance and significantly lowered blood glycosylated hemoglobin levels. On the other hand, compound 5 significantly reduced AST and ALT levels of liver, respectively. Likewise, the kidney functions were improved for both WF and compound 5, whereby both urea and creatinine levels in serum were highly significant Conclusion: The results justify the use of WF and compound 5 of the (HT) epicarp as anti-diabetic agent, taking into consideration that the contents of WF were mainly flavonoids
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Affiliation(s)
- Cicero L T Chang
- Department of Veterinary Medicine, National Chung Hsing University, Taichung 402, Taiwan
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Tanhehco YC, Vogl DT, Stadtmauer EA, O'Doherty U. The evolving role of plerixafor in hematopoietic progenitor cell mobilization. Transfusion 2013; 53:2314-26. [PMID: 23362980 DOI: 10.1111/trf.12102] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 11/09/2012] [Accepted: 11/19/2012] [Indexed: 12/21/2022]
Abstract
The introduction of plerixafor as a peripheral blood stem cell mobilization agent has allowed more patients with multiple myeloma, non-Hodgkin's lymphoma, and Hodgkin's disease to mobilize sufficient hematopoietic progenitor cells (HPCs) to proceed to autologous transplantation. Because of the high cost of plerixafor, it is not routinely used in all patients undergoing HPC mobilization. If cost were not an issue, an argument could be made that plerixafor could be added to every mobilization regimen, but cost is an issue so in an attempt to be more cost-effective, many centers have limited plerixafor use to patients who have failed or who are predicted to fail collection of adequate numbers of cells by other methods. Additionally, plerixafor is now under investigation both for HPC collection of healthy donors for allogeneic stem cell transplantation and as an adjunct therapy (i.e., chemosensitizing agent) for acute leukemias. This article briefly reviews the role of plerixafor in autologous and allogeneic transplantation as well as its emerging role in the treatment of acute leukemias. Emphasis is placed on the choice of appropriate patients for plerixafor use to assure an adequate stem cell yield while maximizing the cost effectiveness of using plerixafor. The role of prophylactic collections and future areas of research are also presented.
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Affiliation(s)
- Yvette C Tanhehco
- Department of Pathology and Cell Biology, Columbia University, New York, New York; Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Sison EAR, Rau RE, McIntyre E, Li L, Small D, Brown P. MLL-rearranged acute lymphoblastic leukaemia stem cell interactions with bone marrow stroma promote survival and therapeutic resistance that can be overcome with CXCR4 antagonism. Br J Haematol 2013; 160:785-97. [PMID: 23294096 DOI: 10.1111/bjh.12205] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 11/28/2012] [Indexed: 02/05/2023]
Abstract
Infants with MLL-rearranged (MLL-R) acute lymphoblastic leukaemia (ALL) have a dismal prognosis. While most patients achieve remission, approximately half of patients recur with a short latency to relapse. This suggests that chemotherapy-resistant leukaemia stem cells (LSCs) survive and can recapitulate the leukaemia. We hypothesized that interactions between LSCs and the bone marrow microenvironment mediate survival and chemotherapy resistance in MLL-R ALL. Using primary samples of infant MLL-R ALL, we studied the influence of bone marrow stroma on apoptosis, proliferation, and cytotoxicity induced by the FLT3 inhibitor lestaurtinib. MLL-R ALL were differentially protected by stroma from spontaneous apoptosis compared to non-MLL-R ALL. Co-culture of bulk MLL-R ALL in direct contact with stroma or with stroma-produced soluble factors promoted proliferation and cell cycle entry. Stroma also protected bulk MLL-R ALL cells and MLL-R ALL LSCs from lestaurtinib-mediated cytotoxicity. Previous studies have demonstrated that CXCR4 mediates bone marrow microenvironment signalling. Using a xenograft model of MLL-R ALL, we demonstrated that CXCR4 inhibition with AMD3100 (plerixafor) led to markedly enhanced efficacy of lestaurtinib. Therefore, the bone marrow microenvironment is a mediator of chemotherapy resistance in MLL-R ALL and targeting leukaemia-stroma interactions with CXCR4 inhibitors may prove useful in this high-risk subtype of paediatric ALL.
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Affiliation(s)
- Edward Allan R Sison
- Oncology and Pediatrics, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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61
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Monitoring blood for CD34+ cells to determine timing of Hematopoietic Progenitor Cells Apheresis. Methods Mol Biol 2012; 904:79-83. [PMID: 22890923 DOI: 10.1007/978-1-61779-943-3_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Hematopoietic Progenitor Cell (HPC) Apheresis generally results in a mononuclear cell product that is highly enriched for hematopoietic stem and progenitor cells when performed on autologous patients in whom autologous stem cell transplant is planned who have been mobilized with cytotoxic chemotherapy and exogenous hematopoietic growth factors (cytokines) and possibly CXCR4 antagonists. Alternatively, patients scheduled for autologous transplants may be mobilized with cytokines only or a combination of cytokines and CXCR4 antagonists. Allogeneic Donors, either matched related donors (MRD) or matched unrelated donors (MUD), are typically mobilized with cytokines only. The HPC Apheresis product, enriched for hematopoietic progenitor cells collected from the patient/donor's peripheral blood via an apheresis system, is used for restoring hematopoiesis in the patient/recipient who has received myeloablative therapy. Timing of the collection of an HPC Apheresis product from allogeneic donors is based on the schedule of the recipient's myeloablative regime. However, the optimal timing of collection on HPC Apheresis product from a patient scheduled for an autologous stem cell transplant can be complex.
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Successful mobilisation of peripheral blood stem cells in children using plerixafor: a case report and review of the literature. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2012; 11:308-10. [PMID: 23114521 DOI: 10.2450/2012.0052-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 05/02/2012] [Indexed: 11/21/2022]
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63
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Abstract
The use of mobilized peripheral blood stem cells (PBSCs) has largely replaced the use of bone marrow as a source of stem cells for both allogeneic and autologous stem cell transplantation. G-CSF with or without chemotherapy is the most commonly used regimen for stem cell mobilization. Some donors or patients, especially the heavily pretreated patients, fail to mobilize the targeted number of stem cells with this regimen. A better understanding of the mechanisms involved in hematopoietic stem cell (HSC) trafficking could lead to the development of newer mobilizing agents and therapeutic approaches. This review will cover the current methods for stem cell mobilization and recent developments in the understanding of the biology of stem cells and the bone marrow microenvironment.
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Affiliation(s)
- Ibraheem H Motabi
- Siteman Cancer Center, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA.
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64
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Yuan S, Nademanee A, Forman SJ, Wang S. Use of plerixafor in patients with Hodgkin lymphoma with poor mobilization of peripheral blood stem cells. Leuk Lymphoma 2012; 54:646-8. [DOI: 10.3109/10428194.2012.713480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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65
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Vettenranta K, Möttönen M, Riikonen P. The use of plerixafor in harvesting autologous stem cells in the pediatric setting. Pediatr Blood Cancer 2012; 59:197-8. [PMID: 22012661 DOI: 10.1002/pbc.23361] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 08/31/2011] [Indexed: 11/09/2022]
Abstract
The mobilization of stem cells using the standard approach, chemotherapy and G-CSF, may not be successful in all cases heavily pretreated. Plerixafor (AMD3100) has emerged as a viable option in attempts to mobilize stem cells among these patients. The use of plerixafor in the adult setting has been established, but data on pediatric use is scarce. We report on the use of plerixafor in eight pediatric cases either as add-on to chemotherapy plus G-CSF or in remobilization.
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Affiliation(s)
- Kim Vettenranta
- Division of Pediatric Hematology-Oncology, University of Tampere, Tampere, Finland.
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Kaufman JL, Flowers CR, Rados KD, Calandra GB, Vose JM, Hewes LB, Lonial S, Langston AA, Khoury HJ, Lechowicz MJ, Waller EK. A prospective clinical trial evaluating the safety and efficacy of the combination of rituximab and plerixafor as a mobilization regimen for patients with lymphoma. Transfusion 2012; 53:76-84. [PMID: 22624594 DOI: 10.1111/j.1537-2995.2012.03719.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Previous reports suggested that rituximab may impair stem cell collection and posttransplant engraftment in lymphoma patients undergoing autologous hematopoietic progenitor cell transplantation. STUDY DESIGN AND METHODS A prospective biologic allocation study examined the effect of adding rituximab to a mobilization regimen of plerixafor and granulocyte-colony-stimulating factor (G-CSF) for patients with CD20+ lymphoma compared with CD20- lymphoma patients mobilized without rituximab. The primary endpoint was safety of the rituximab-containing regimen; secondary endpoints compared the efficiency of stem cell collection, posttransplant engraftment, graft characteristics, mobilization kinetics, immune reconstitution, and engraftment durability between the cohorts of patients with CD20+ and CD20- lymphoma. RESULTS Fifteen subjects assigned to each treatment arm were accrued. Both mobilization regimens had similar toxicities. The median number of CD34+ cells collected (7.4 × 10(6) /kg vs. 6.4 × 10(6) /kg) and the median numbers of days of apheresis needed to collect stem cells were not different between the CD20+ and CD20- cohorts. No significant differences in neutrophil engraftment (median, 13.5 days vs. 13 days) or platelet engraftment (22 vs. 21 days) or in graft durability were seen comparing patients with CD20+ versus CD20- lymphoma. There were no significant differences in the kinetics of blood T-cell or natural killer-cell reconstitution comparing the two groups. B-cell reconstitution was delayed in the CD20+ lymphoma group, but this did not translate into a significant increase in infectious complications. CONCLUSION Rituximab can be safely added to the combination of plerixafor and G-CSF as a mobilization strategy without excess toxicity or posttransplant engraftment delays for patients with chemosensitive lymphoma undergoing autologous hematopoietic progenitor cell transplantation.
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Affiliation(s)
- Jonathan L Kaufman
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
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67
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Rettig MP, Ansstas G, DiPersio JF. Mobilization of hematopoietic stem and progenitor cells using inhibitors of CXCR4 and VLA-4. Leukemia 2012; 26:34-53. [PMID: 21886173 PMCID: PMC3514440 DOI: 10.1038/leu.2011.197] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 03/31/2011] [Accepted: 05/23/2011] [Indexed: 12/29/2022]
Abstract
Successful hematopoietic stem cell transplant requires the infusion of a sufficient number of hematopoietic stem/progenitor cells (HSPCs) that are capable of homing to the bone marrow cavity and regenerating durable trilineage hematopoiesis in a timely manner. Stem cells harvested from peripheral blood are the most commonly used graft source in HSCT. Although granulocyte colony-stimulating factor (G-CSF) is the most frequently used agent for stem cell mobilization, the use of G-CSF alone results in suboptimal stem cell yields in a significant proportion of patients. Both the chemokine receptor CXCR4 and the integrin α(4)β(1) (very late antigen 4 (VLA-4)) have important roles in the homing and retention of HSPCs within the bone marrow microenvironment. Preclinical and/or clinical studies have shown that targeted disruption of the interaction of CXCR4 or VLA-4 with their ligands results in the rapid and reversible mobilization of hematopoietic stem cells into the peripheral circulation and is synergistic when combined with G-CSF. In this review, we discuss the development of small-molecule CXCR4 and VLA-4 inhibitors and how they may improve the utility and convenience of peripheral blood stem cell transplantation.
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Affiliation(s)
- M P Rettig
- Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St Louis, MO 63110, USA
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68
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Jantunen E. Novel strategies for blood stem cell mobilization: special focus on plerixafor. Expert Opin Biol Ther 2011; 11:1241-8. [PMID: 21806478 DOI: 10.1517/14712598.2011.601737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION More than 98% of autologous stem cell transplants are now performed with the support of mobilized blood stem cells, and the proportion of allogeneic blood stem cell transplants has risen to more than 70%. Blood stem cell mobilization strategies are therefore important components of all transplant programs. AREAS COVERED Stem cell mobilization strategies are evaluated based on current literature, with special focus on the use of plerixafor, a CXCR4 chemokine receptor antagonist. Mobilization methods in autologous settings include the use of G-CSF alone or following chemotherapy (chemomobilization), and the use of G-CSF alone in allogeneic transplants. A combination of G-CSF + plerixafor has been shown to be effective in patients who have failed a previous mobilization. This combination has also been found to be superior to G-CSF alone in Phase III studies in myeloma and non-Hodgkin lymphoma patients as the first-line mobilization. EXPERT OPINION Addition of plerixafor to chemomobilization or G-CSF mobilization may be more cost-effective than its routine use, and it is worth considering in predicted or proven poor mobilizers. Novel mobilization strategies have allowed more successful stem cell collection in autologous setting, although the effect of plerixafor on graft content and long-term patient outcomes needs further investigation.
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Affiliation(s)
- Esa Jantunen
- University of Eastern Finland, and Kuopio University Hospital, Department of Medicine, POB 1777, 70211 Kuopio, Finland.
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69
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Long-Term Outcome after Autologous Stem Cell Transplantation with Adequate Peripheral Blood Stem Cell Mobilization Using Plerixafor and G-CSF in Poor Mobilizer Lymphoma and Myeloma Patients. Adv Hematol 2011; 2011:517561. [PMID: 22190942 PMCID: PMC3235426 DOI: 10.1155/2011/517561] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 09/26/2011] [Accepted: 10/11/2011] [Indexed: 12/29/2022] Open
Abstract
Poor peripheral blood stem cell (PBSC) mobilization predicts worse outcome for myeloma and lymphoma patients post autologous stem cell transplant (ASCT). We hypothesize that PBSC harvest using plerixafor and G-CSF in poor mobilizers may improve long-term outcome. We retrospectively analyzed the data on patients who had second PBSC mobilization using plerixafor and G-CSF as a rescue. Nine lymphoma and 8 multiple myeloma (MM) patients received the drug. A control group of 25 MM and lymphoma patients who were good mobilizers with G-CSF only was used for comparison. Sixteen of the 17 poor mobilizers proceeded to ASCT, and one MM patient had tandem transplants. Length of hospital stay, infection incidence, granulocyte engraftment, and long-term hematopoietic recovery were not significantly different between the two groups. In conclusion, all poor mobilizers were able to obtain adequate stem cells transplant dose and had similar transplant course and long-term outcome to that of the control good mobilizers group.
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Hübel K, Fresen MM, Apperley JF, Basak GW, Douglas KW, Gabriel IH, Geraldes C, Jaksic O, Koristek Z, Kröger N, Lanza F, Lemoli RM, Mikala G, Selleslag D, Worel N, Mohty M, Duarte RF. European data on stem cell mobilization with plerixafor in non-Hodgkin's lymphoma, Hodgkin's lymphoma and multiple myeloma patients. A subgroup analysis of the European Consortium of stem cell mobilization. Bone Marrow Transplant 2011; 47:1046-50. [PMID: 22080971 DOI: 10.1038/bmt.2011.216] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The effectiveness of the novel hematopoietic stem cell mobilizing agent plerixafor was evaluated in nationwide compassionate use programs in 13 European countries. A total of 580 poor mobilizers with non-Hodgkin's lymphoma (NHL), Hodgkin's lymphoma (HL) and multiple myeloma (MM) were enrolled. All patients received plerixafor plus granulocyte CSF with or without chemotherapy. Overall, the collection yield was significantly higher in MM patients (>2.0 × 10(6) CD34+ cells/kg: 81.6%; >5.0 × 10(6) CD34+ cells/kg: 32.0%) than in NHL patients (>2.0 × 10(6) CD34+ cells/kg: 64.8%; >5.0 × 10(6) CD34+ cells/kg: 12.6%; P<0.0001) and also significantly higher in HL patients (>2.0 × 10(6) CD34+ cells/kg: 81.5%; >5.0 × 10(6) CD34+ cells/kg: 22.2%) than in NHL patients (P=0.013). In a subgroup analysis, there were no significant differences in mobilization success comparing patients with diffuse large B-cell lymphoma, follicular lymphoma and mantle cell lymphoma. Our data emphasize the role of plerixafor in poor mobilizers, but further strategies to improve the apheresis yield especially in patients with NHL are required.
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Affiliation(s)
- K Hübel
- Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany
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71
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Stamatopoulos B, Meuleman N, De Bruyn C, Pieters K, Mineur P, Le Roy C, Saint-Georges S, Varin-Blank N, Cymbalista F, Bron D, Lagneaux L. AMD3100 disrupts the cross-talk between chronic lymphocytic leukemia cells and a mesenchymal stromal or nurse-like cell-based microenvironment: pre-clinical evidence for its association with chronic lymphocytic leukemia treatments. Haematologica 2011; 97:608-15. [PMID: 22058221 DOI: 10.3324/haematol.2011.052779] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Interactions with the microenvironment, such as bone marrow mesenchymal stromal cells and nurse-like cells, protect chronic lymphocytic leukemia cells from spontaneous and drug-induced apoptosis. This protection is partially mediated by the chemokine SDF-1α (CXCL12) and its receptor CXCR4 (CD184) present on the chronic lymphocytic leukemia cell surface. DESIGN AND METHODS Here, we investigated the ability of AMD3100, a CXCR4 antagonist, to sensitize chronic lymphocytic leukemia cells to chemotherapy in a chronic lymphocytic leukemia/mesenchymal stromal cell based or nurse-like cell based microenvironment co-culture model. RESULTS AMD3100 decreased CXCR4 expression signal (n=15, P=0.0078) and inhibited actin polymerization/migration in response to SDF-1α (n=8, P<0.01) and pseudoemperipolesis (n=10, P=0.0010), suggesting that AMD3100 interferes with chronic lymphocytic leukemia cell trafficking. AMD3100 did not have a direct effect on apoptosis when chronic lymphocytic leukemia cells were cultured alone (n=10, P=0.8812). However, when they were cultured with SDF-1α, mesenchymal stromal cells or nurse-like cells (protecting them from apoptosis, P<0.001), chronic lymphocytic leukemia cell pre-treatment with AMD3100 significantly inhibited these protective effects (n=8, P<0.01) and decreased the expression of the anti-apoptotic proteins MCL-1 and FLIP. Furthermore, combining AMD3100 with various drugs (fludarabine, cladribine, valproïc acid, bortezomib, flavopiridol, methylprednisolone) in our mesenchymal stromal cell co-culture model enhanced drug-induced apoptosis (n=8, P<0.05) indicating that AMD3100 could mobilize chronic lymphocytic leukemia cells away from their protective microenvironment, making them more accessible to conventional therapies. CONCLUSIONS Taken together, these data demonstrate that interfering with the SDF-1α/CXCR4 axis by using AMD3100 inhibited chronic lymphocytic leukemia cell trafficking and microenvironment-mediated protective effects. Combining AMD3100 with other drugs may, therefore, represent a promising therapeutic approach to kill chronic lymphocytic leukemia cells.
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Affiliation(s)
- Basile Stamatopoulos
- Université Libre de Bruxelles, Institut Jules Bordet, Laboratoire de Thérapie Cellulaire Clinique (LTCC), Boulevard de Waterloo 121, 1000 Bruxelles, Belgium.
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72
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Schroeder MA, DiPersio JF. Mobilization of hematopoietic stem and leukemia cells. J Leukoc Biol 2011; 91:47-57. [PMID: 22028335 DOI: 10.1189/jlb.0210085] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
HSC mobilization is an essential homeostatic process during inflammation and for the maintenance of hematopoietic progenitors. It has been exploited for the therapeutic application of HSC transplantation. Recent evidence suggests that leukemic cells share surface molecules in common with stem cells and may be mobilized under similar conditions. This effect could be used for therapeutic interventions. In this review, we will provide evidence showing that leukemia cells and stem cells traffic similarly and may share a common niche. Studies are discussed comparing and contrasting the mechanism of normal stem cells and leukemic cell mobilization through the CXCR4/CXCL12 axis and other key intermediaries.
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Affiliation(s)
- Mark A Schroeder
- Division of Oncology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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73
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Berchanski A, Kalinkovich A, Ludin A, Lapidot T, Lapidot A. Insights into the mechanism of enhanced mobilization of hematopoietic progenitor cells and release of CXCL12 by a combination of AMD3100 and aminoglycoside-polyarginine conjugates. FEBS J 2011; 278:4150-65. [PMID: 21910828 DOI: 10.1111/j.1742-4658.2011.08348.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mobilization of hematopoietic stem and progenitor cells (HSPCs) from the bone marrow to the peripheral blood is utilized in clinical HSPC transplantation protocols. Retention of HSPCs in the bone marrow is determined by relationships between the chemokine chemokine (C-X-C motif) ligand 12 (CXCL12) and its major receptor C-X-C chemokine receptor type 4 (CXCR4), and disruption of this retention by CXCR4 antagonists such as AMD3100 induces rapid HSPC mobilization. Here, we report that aminoglycoside-polyarginine conjugates (APACs) and N-α-acetyl-nona-D-arginine (r9) induce mobilization of white blood cells and, preferentially, immature hematopoietic progenitor cells (HPCs) in mice, similarly to AMD3100. Remarkably, administration of AMD3100 with each one of the APACs or r9 caused additional HPC mobilization. The mobilizing activity of APACs and r9 was accompanied by a significant elevation in plasma CXCL12 levels. To further understand how APACs, r9 and their combinations with AMD3100 compete with CXCL12 binding to CXCR4, as well with antibody against CXCR4 for CXCR4 binding, we have undertaken an approach combining experimental validation and docking to determine plausible binding modes for these ligands. On the basis of our biological and docking findings, and recently published NMR data, we suggest that combination of pairs of compounds such as APACs (or r9) with AMD3100 induces more efficient disruption of the CXCL12-CXCR4 interaction than AMD3100 alone, resulting in enhanced HPC mobilization.
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Affiliation(s)
- Alexander Berchanski
- Department of Organic Chemistry, The Weizmann Institute of Science, Rehovot, Israel
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74
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Novel agents and approaches for stem cell mobilization in normal donors and patients. Bone Marrow Transplant 2011; 47:1154-63. [DOI: 10.1038/bmt.2011.170] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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75
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76
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La mobilisation des progéniteurs hématopoïétiques : nouvelles cibles et nouvelles modalités thérapeutiques. Bull Cancer 2011; 98:951-61. [DOI: 10.1684/bdc.2011.1405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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77
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Dar A, Schajnovitz A, Lapid K, Kalinkovich A, Itkin T, Ludin A, Kao WM, Battista M, Tesio M, Kollet O, Cohen NN, Margalit R, Buss EC, Baleux F, Oishi S, Fujii N, Larochelle A, Dunbar CE, Broxmeyer HE, Frenette PS, Lapidot T. Rapid mobilization of hematopoietic progenitors by AMD3100 and catecholamines is mediated by CXCR4-dependent SDF-1 release from bone marrow stromal cells. Leukemia 2011; 25:1286-1296. [PMID: 21494253 PMCID: PMC4175714 DOI: 10.1038/leu.2011.62] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 02/10/2011] [Accepted: 02/23/2011] [Indexed: 12/14/2022]
Abstract
Steady-state egress of hematopoietic progenitor cells can be rapidly amplified by mobilizing agents such as AMD3100, the mechanism, however, is poorly understood. We report that AMD3100 increased the homeostatic release of the chemokine stromal cell derived factor-1 (SDF-1) to the circulation in mice and non-human primates. Neutralizing antibodies against CXCR4 or SDF-1 inhibited both steady state and AMD3100-induced SDF-1 release and reduced egress of murine progenitor cells over mature leukocytes. Intra-bone injection of biotinylated SDF-1 also enhanced release of this chemokine and murine progenitor cell mobilization. AMD3100 directly induced SDF-1 release from CXCR4(+) human bone marrow osteoblasts and endothelial cells and activated uPA in a CXCR4/JNK-dependent manner. Additionally, ROS inhibition reduced AMD3100-induced SDF-1 release, activation of circulating uPA and mobilization of progenitor cells. Norepinephrine treatment, mimicking acute stress, rapidly increased SDF-1 release and progenitor cell mobilization, whereas β2-adrenergic antagonist inhibited both steady state and AMD3100-induced SDF-1 release and progenitor cell mobilization in mice. In conclusion, this study reveals that SDF-1 release from bone marrow stromal cells to the circulation emerges as a pivotal mechanism essential for steady-state egress and rapid mobilization of hematopoietic progenitor cells, but not mature leukocytes.
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Affiliation(s)
- Ayelet Dar
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Amir Schajnovitz
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Kfir Lapid
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Tomer Itkin
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Aya Ludin
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Wei-Ming Kao
- Department of Medicine, Immunology Institute, and Black Family Stem Cell Institute, Mount Sinai School of Medicine, New York, New York, USA
| | - Michela Battista
- Department of Medicine, Immunology Institute, and Black Family Stem Cell Institute, Mount Sinai School of Medicine, New York, New York, USA
| | - Melania Tesio
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Orit Kollet
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Neta Netzer Cohen
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Raanan Margalit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Eike C. Buss
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | | | - Shinya Oishi
- Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Nobutaka Fujii
- Graduate School of Pharmaceutical Sciences, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Andre Larochelle
- Molecular Hematopoiesis Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cynthia E. Dunbar
- Molecular Hematopoiesis Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Hal E. Broxmeyer
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indianapolis, USA
| | - Paul S. Frenette
- Department of Medicine, Immunology Institute, and Black Family Stem Cell Institute, Mount Sinai School of Medicine, New York, New York, USA
| | - Tsvee Lapidot
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
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Hübel K, Fresen MM, Salwender H, Basara N, Beier R, Theurich S, Christopeit M, Bogner C, Galm O, Hartwig R, Heits F, Lordick F, Rösler W, Wehler D, Zander AR, Albert MH, Dressler S, Ebinger M, Frickhofen N, Hertenstein B, Kiehl M, Liebler S, von Lilienfeld-Toal M, Weidmann E, Weigelt C, Lange F, Kröger N. Plerixafor with and without chemotherapy in poor mobilizers: results from the German compassionate use program. Bone Marrow Transplant 2011; 46:1045-52. [PMID: 20972470 DOI: 10.1038/bmt.2010.249] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 06/28/2010] [Accepted: 08/23/2010] [Indexed: 11/09/2022]
Abstract
The CXCR4-inhibitor plerixafor mobilizes hematopoietic stem cells amplifying the effects of granulocyte-CSF (G-CSF). Before approval plerixafor was used in a compassionate use program (CUP) for patients who failed a previous mobilization. In the German CUP 60 patients from 23 centers (median age 56.5 years (2-75)) were given 240 μg/kg plerixafor SC 9-11 h before apheresis. A total of 78.3% (47/60) received G-CSF for 4 days before plerixafor administration; 76.6% of those (36/47) yielded at least 2.0 × 10(6) CD34(+) cells/μL. The median cell yield was 3.35 × 10(6) CD34+ cells/kg (0-29.53). Nine patients received plerixafor alone or with G-CSF for less than 4 days mobilizing a median of 3.30 × 10(6) CD34+ cells/kg (1.6-5.6). There was no significant difference between G-CSF application for 4 days and for a shorter period of time (P=0.157). A total of 47 patients received plerixafor plus G-CSF combined with chemotherapy yielding a median of 3.28 × 10(6) CD34+ cells/kg (0-24.79). In all, 40 of 60 patients (66.7%) proceeded to transplantation, and achieved a timely and stable engraftment. Side effects were rare and manageable. In conclusion, mobilization with plerixafor in poor mobilizers is safe and results in a sufficient stem cell harvest in the majority of patients.
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Affiliation(s)
- K Hübel
- University Hospital of Cologne, Cologne, Germany.
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79
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Cooper DL, Pratt K, Baker J, Medoff E, Conkling-Walsh A, Foss F, Snyder E, Yen W, Seropian SE. Late Afternoon Dosing of Plerixafor for Stem Cell Mobilization: A Practical Solution. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2011; 11:267-72. [DOI: 10.1016/j.clml.2011.03.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 11/11/2010] [Accepted: 11/22/2010] [Indexed: 10/18/2022]
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Mohty M, Ho AD. In and out of the niche: perspectives in mobilization of hematopoietic stem cells. Exp Hematol 2011; 39:723-9. [PMID: 21624427 DOI: 10.1016/j.exphem.2011.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 04/23/2011] [Accepted: 05/02/2011] [Indexed: 01/01/2023]
Abstract
Several stem cell mobilization strategies have been employed in the past 2 decades, including chemotherapy, hematopoietic growth factors, and chemotherapy plus growth factors. Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage CSF are standard agents approved for peripheral blood stem cell mobilization since the early 1990s. Between 5% and 20% of patients, however, fail to mobilize a sufficient numbers of peripheral blood stem cells in response to G-CSF with or without chemotherapy. Recent advances in defining the basic mechanisms regulating the interactions between hematopoietic stem cells and their marrow niche had led to the discovery that CXCR4 and stromal-cell-derived factor 1α axis play a significant role. Plerixafor, an antagonist of the CXCR4-stromal-cell-derived factor 1α axis has been shown to result in a significant mobilization of hematopoietic stem cells. Numerous clinical trials have demonstrated that the combination of G-CSF and AMD3100 (G+A) resulted in a significant increase in CD34(+) cell yield as compared to the administration of G-CSF alone. In particular, the progenitors mobilized have been shown to comprise a significantly higher proportion of primitive and possibly more potent CD34(+)/CD38(-) subpopulation. Transplantation of PBSC mobilized by G+A administration have led to a rapid and sustained neutrophil and platelet engraftment. Another prospective role of this new class of agents might lie in the mobilization of dormant leukemia stem cells that are well protected by the niche. The future role of CXCR4 antagonists in treatment of hematologic malignancies includes mobilization of hematopoietic stem cells for transplantation and mobilization of leukemia-initiating cells for long-term cure.
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Affiliation(s)
- Mohamad Mohty
- Centre Hospitalier et Universitaire (CHU) de Nantes, Hématologie Clinique, Nantes, France.
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81
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Li J, Hamilton E, Vaughn L, Graiser M, Renfroe H, Lechowicz MJ, Langston A, Prichard JM, Anderson D, Gleason C, Lonial S, Flowers CR, Kaufman JL, Waller EK. Effectiveness and cost analysis of “just-in-time” salvage plerixafor administration in autologous transplant patients with poor stem cell mobilization kinetics. Transfusion 2011; 51:2175-82. [DOI: 10.1111/j.1537-2995.2011.03136.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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82
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Damon LE, Damon LE. Mobilization of hematopoietic stem cells into the peripheral blood. Expert Rev Hematol 2011; 2:717-33. [PMID: 21082960 DOI: 10.1586/ehm.09.54] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hematopoietic stem cells can be mobilized out of the bone marrow into the blood for the reconstitution of hematopoiesis following high-dose therapy. Methods to improve mobilization efficiency and yields are rapidly emerging. Traditional methods include chemotherapy with or without myeloid growth factors. Plerixafor, a novel agent that disrupts the CXCR4-CXCL12 bond, the primary hematopoietic stem cell anchor in the bone marrow, has recently been US FDA-approved for mobilizing hematopoietic stem cells in patients with non-Hodgkin lymphoma and multiple myeloma. Plerixafor and myeloid growth factors as single agents appear safe to use in family or volunteer hematopoietic stem cells donors. Plerixafor mobilizes leukemic stem cells and is not approved for use in patients with acute leukemia. Patients failing to mobilize adequate hematopoietic stem cells with myeloid growth factors can often be successfully mobilized with chemotherapy plus myeloid growth factors or with plerixafor and granulocyte colony-stimulating factor.
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Affiliation(s)
- Lloyd E Damon
- Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143-0324, USA.
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83
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Moreb JS. Plerixafor in non-Hodgkin’s lymphoma and multiple myeloma patients undergoing autologous stem cell transplantation. Oncol Rev 2011. [DOI: 10.1007/s12156-010-0062-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Pelus LM, Farag SS. Increased mobilization and yield of stem cells using plerixafor in combination with granulocyte-colony stimulating factor for the treatment of non-Hodgkin's lymphoma and multiple myeloma. STEM CELLS AND CLONING-ADVANCES AND APPLICATIONS 2011; 4:11-22. [PMID: 24198526 PMCID: PMC3781755 DOI: 10.2147/sccaa.s6713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Multiple myeloma and non-Hodgkin’s lymphoma remain the most common indications for high-dose chemotherapy and autologous peripheral blood stem cell rescue. While a CD34+ cell dose of 1 × 106/kg is considered the minimum required for engraftment, higher CD34+ doses correlate with improved outcome. Numerous studies, however, support targeting a minimum CD34+ cell dose of 2.0 × 106/kg, and an “optimal” dose of 4 to 6 × 106/kg for a single transplant. Unfortunately, up to 40% of patients fail to mobilize an optimal CD34+ cell dose using myeloid growth factors alone. Plerixafor is a novel reversible inhibitor of CXCR4 that significantly increases the mobilization and collection of higher numbers of hematopoietic progenitor cells. Two randomized multi-center clinical trials in patients with non-Hodgkin’s lymphoma and multiple myeloma have demonstrated that the addition of plerixafor to granulocyte-colony stimulating factor increases the mobilization and yield of CD34+ cells in fewer apheresis days, which results in durable engraftment. This review summarizes the pharmacology and evidence for the clinical efficacy of plerixafor in mobilizing hematopoietic stem and progenitor cells, and discusses potential ways to utilize plerixafor in a cost-effective manner in patients with these diseases.
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Affiliation(s)
- Louis M Pelus
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana
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85
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The role of plerixafor in optimizing peripheral blood stem cell mobilization for autologous stem cell transplantation. Leukemia 2011; 25:1-6. [PMID: 21224858 DOI: 10.1038/leu.2010.224] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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86
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Jantunen E, Kvalheim G. Mobilization strategies in hard-to-mobilize patients with lymphoid malignancies. Eur J Haematol 2010; 85:463-71. [PMID: 20738393 DOI: 10.1111/j.1600-0609.2010.01520.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Depending on definitions and patient characteristics, 5-40% of patients with lymphoid malignancies are hard-to-mobilize. Several premobilization factors such as previous chemotherapy (CT), disease, marrow infiltration and platelet count at the time of mobilization influence the efficacy of CD34(+) cell mobilization. In general, however, prediction of hard-to-mobilize patient is difficult. Postmobilization factors especially low blood CD34(+) counts are important in clinical practice as we have now ways to enhance mobilization at this point. Plerixafor combined with granulocyte-colony stimulating factor (G-CSF) has significantly increased efficacy of remobilization in patients who have failed a previous mobilization attempt with a success rate of about 70%. Addition of plerixafor to G-CSF or more recently to a mobilization regimen consisting of CT + G-CSF is promising as blood CD34(+) counts can be increased three to fivefold to facilitate effective collection with less aphaeresis sessions. As plerixafor is expensive, development of practical algorithms for its use is important to make blood stem cell mobilization and collection more efficient in a cost-effective way. This review attempts to summarize current treatment strategies in hard-to-mobilize patients with lymphoid malignancies.
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Affiliation(s)
- Esa Jantunen
- University of Eastern Finland/Institute of Clinical Medicine, Kuopio, Finland.
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87
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Update on clinical experience with AMD3100, an SDF-1/CXCL12-CXCR4 inhibitor, in mobilization of hematopoietic stem and progenitor cells. Curr Opin Hematol 2010; 17:319-26. [PMID: 20473162 DOI: 10.1097/moh.0b013e328338b7d5] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW Mobilized peripheral blood stem cells are increasingly used for the reconstitution of hematopoiesis in autologous and allogeneic transplants. New agents and approaches are emerging to improve mobilization efficacy while reducing duration and toxicity of mobilization. The purpose of this review is to overview clinical experience with AMD3100 (plerixafor) and its role in stem cell mobilization. RECENT FINDINGS AMD3100 is a bicyclam molecule that selectively and reversibly antagonizes the binding of stromal cell-derived factor-1 (SDF-1) to its receptor CXC motif receptor-4 (CXCR4) with subsequent egress of hematopoietic stem cells to the peripheral blood. AMD3100 safely and rapidly mobilizes stem cells in patients with lymphoma, myeloma and healthy donors, and is synergistic in combination with granulocyte-colony stimulating factor. In addition, AMD3100 disrupts the interaction between mouse and human leukemic blasts and the bone marrow stroma, mobilizing blasts to the peripheral blood and sensitizing them to chemotherapy. SUMMARY AMD3100 was recently FDA-approved for stem cell mobilization in combination with granulocyte-colony stimulating factor in patients with non-Hodgkin's lymphoma and multiple myeloma. Studies are underway testing AMD3100 as an adjunct to chemotherapy in patients with refractory acute myelogenous leukemia (and other hematologic malignancies), as a strategy to sensitize leukemic cells to chemotherapy and improve clinical outcomes.
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88
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De Clercq E. Recent advances on the use of the CXCR4 antagonist plerixafor (AMD3100, Mozobil™) and potential of other CXCR4 antagonists as stem cell mobilizers. Pharmacol Ther 2010; 128:509-18. [PMID: 20826182 DOI: 10.1016/j.pharmthera.2010.08.009] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AMD3100 was originally discovered as an anti-HIV agent effective in inhibiting the replication of HIV in vitro at nanomolar concentrations. We found it to be a potent and selective antagonist of CXCR4, the receptor for the chemokine SDF-1 (now called CXCL12). AMD3100 was then developed, and marketed, as a stem cell mobilizer, and renamed plerixafor (Mozobil™). The path to the discovery of Mozobil™ as a stem cell mobilizer was described in Biochem. Pharmacol. 77: 1655-1664 (2009). Here I review the recent advances that have consolidated the role of plerixafor in mobilizing hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs) from the bone marrow into the blood circulation. Plerixafor acts synergistically with granulocyte colony-stimulating factor (G-CSF), and its usefulness has been proven particularly for the mobilization of HSCs and HPCs for autologous stem cell transplantation in patients with non-Hodgkin's lymphoma (NHL) or multiple myeloma (MM). Plerixafor also has great potential for the treatment of hematological malignancies other than NHL and MM, and non-hematological malignancies, and, eventually, several other diseases depending on the CXCL12-CXCR4 interaction. Various AMD3100 analogs have been described (i.e. AMD11070, AMD3465, KRH-3955, T-140, and 4F-benzoyl-TN14003), primarily as potential anti-HIV agents. They are all strong CXCR4 antagonists. Their role in stem cell mobilization remains to be assessed.
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Affiliation(s)
- Erik De Clercq
- Rega Institute for Medical Research, K.U.Leuven, Minderbroedersstraat 10, B-3000 Leuven, Belgium.
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89
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Kessans MR, Gatesman ML, Kockler DR. Plerixafor: a peripheral blood stem cell mobilizer. Pharmacotherapy 2010; 30:485-92. [PMID: 20411999 DOI: 10.1592/phco.30.5.485] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Autologous hematopoietic stem cell (HSC) transplantation is a treatment strategy for restoring normal hematopoietic function in patients with select hematologic malignancies. The number of CD34(+) cells available for transplantation has been reported to be the strongest predictor of transplantation success, as measured by rapid and durable hematopoietic recovery. Currently, granulocyte colony-stimulating factor (G-CSF) alone or G-CSF plus chemotherapy are the most commonly used methods for stem cell mobilization. Unfortunately, 5-30% of patients do not respond to these agents. Plerixafor is a new HSC mobilizing drug that antagonizes the binding of chemokine stromal-cell-derived factor-1alpha (SDF-1alpha) to CXC chemokine receptor 4 (CXCR4). It is indicated in combination with G-CSF to mobilize HSC to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM). Results of clinical trials have shown that plerixafor plus G-CSF allow for the collection of a high yield of HSC with fewer apheresis sessions in patients with NHL and MM. Plerixafor has also shown promising results in small studies enrolling patients with Hodgkin's lymphoma. Moreover, for patients who fail G-CSF mobilization alone, plerixafor with G-CSF may be useful as a salvage mobilization strategy. Overall, plerixafor has been generally well tolerated with adverse effects classified as mild to moderate. The most common adverse effects reported in randomized clinical trials were injection site reactions and diarrhea, with approximately 33% of patients experiencing these effects. To our knowledge, clinical trials comparing G-CSF plus plerixafor with G-CSF plus chemotherapy and cost-effectiveness analyses have not been published; therefore, questions remain regarding the optimal role of plerixafor in the clinical practice setting.
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Affiliation(s)
- Mika R Kessans
- Department of Pharmacy, University of Louisville Hospital, Louisville, Kentucky, USA
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90
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Fesler MJ, Nguyen NC, Petruska PJ. Modified escalated BEACOPP as salvage chemotherapy in classic Hodgkin lymphoma. Int J Hematol 2010; 92:211-3. [DOI: 10.1007/s12185-010-0630-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 05/15/2010] [Accepted: 06/06/2010] [Indexed: 10/19/2022]
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91
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Murakami T, Yamamoto N. Role of CXCR4 in HIV infection and its potential as a therapeutic target. Future Microbiol 2010; 5:1025-39. [DOI: 10.2217/fmb.10.67] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The chemokine receptors CCR5 and CXCR4 are the two major coreceptors for HIV entry. Numerous efforts have been made to develop a new class of anti-HIV agents that target these coreceptors as an additional or alternative therapy to standard HAART. Among the CCR5 inhibitors developed so far, maraviroc is the first drug that has been approved by the US FDA for treating patients with R5 HIV-1. Although many CXCR4 inhibitors, some of which are highly active and orally bioavailable, have also been studied, they are still at preclinical stages or have been suspended during development. Importantly, the interaction between CXCR4 and its ligand SDF-1 is involved in various disease conditions, such as cancer cell metastasis, leukemia cell proliferation, rheumatoid arthritis and pulmonary fibrosis. Therefore, CXCR4 inhibitors have potential as novel therapeutics for the treatment of these diseases as well as HIV infection.
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Affiliation(s)
- Tsutomu Murakami
- AIDS Research Center, National Institute of Infectious Diseases, 1–23–1 Toyama, Shinjuku-ku, Tokyo 162–8640 Japan
| | - Naoki Yamamoto
- Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore 5 Science Drive 2, Blk MD4A, Level 5, 117597 Singapore
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92
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Flomenberg N, Comenzo RL, Badel K, Calandra G. Plerixafor (Mozobil®) Alone to Mobilize Hematopoietic Stem Cells from Multiple Myeloma Patients for Autologous Transplantation. Biol Blood Marrow Transplant 2010; 16:695-700. [DOI: 10.1016/j.bbmt.2009.12.538] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 12/31/2009] [Indexed: 02/08/2023]
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93
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Flatt T, Lewing K, Gonzalez C, Anthony K, Ryan R, Jones R, Gamis A, Dalal J. Successful mobilization with AMD3100 and filgrastim with engraftment of autologous peripheral blood stem cells in a heavily pretreated pediatric patient with recurrent Burkitt lymphoma. Pediatr Hematol Oncol 2010; 27:138-49. [PMID: 20201695 DOI: 10.3109/08880010903447367] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The authors report a case of a 13-year-old female with recurrent Burkitt lymphoma who was heavily pretreated with chemotherapy. During chemotherapy for relapse, she developed serious aspergillus infection of the palate and sinuses. Despite 10 microg/kg of filgrastim for 5 days, peripheral blood CD34(+) cells remained <or=1/microL. Hematopoietic progenitor cells were subsequently successfully mobilized with a combination of AMD3100 and filgrastim without tumor or fungus contamination. After transplantation, the patient achieved complete engraftment without exacerbation of fungal infection. This is the first case report of a pediatric patient with relapsed Burkitt lymphoma with mobilization of hematopoietic progenitor cells by AMD3100 without any adverse reactions.
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Affiliation(s)
- Terrie Flatt
- The Children's Mercy Hospital, Department of Hematology/Oncology, 2401 Gillham Rd, Kansas City, MO 64108, USA.
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94
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Rosenbeck LL, Srivastava S, Kiel PJ. Peripheral Blood Stem Cell Mobilization Tactics. Ann Pharmacother 2010; 44:107-16. [DOI: 10.1345/aph.1m289] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To evaluate the methods and collection techniques currently used in stem cell mobilization for patients undergoing autologous transplantation. DATA SOURCES Literature search was performed through PubMed (1948-August 2009) and MEDLINE (1977-August 2009). Reference citations from publications identified were also reviewed. STUDY SELECTION AND DATA EXTRACTION All literature identified was reviewed for inclusion. Original research and retrospective cohorts, along with previously published systematic reviews of stem cell mobilization and growth factors, were evaluated. Abstract data on plerixafor were also reviewed. DATA SYNTHESIS Successful mobilization of an adequate number of progenitor cells can help ensure and improve time to neutrophil and platelet engraftment. A variety of methods have been studied to find the safest and most predictable mobilization of CD34+ progenitor cells, including use of single agents or the combinations of hematopoietic growth factors, chemotherapy, and a novel chemokine receptor 4 antagonist. Currently, granulocyte colony-stimulating factor (G-CSF) 10 Mg/kg daily started 4 days prior to apheresis remains the standard of care for initial mobilization therapy. In patients who fail to mobilize or who are at high risk for mobilization failure, cyclophosphamide in conjunction with G-CSF may be used. Plerixafor, a novel chemokine receptor antagonist, in combination with G-CSF has demonstrated superiority for achieving collection goals compared to G-CSF alone in 2 Phase 3 trials. CONCLUSIONS The optimal mobilization strategy is still unknown; however, colony-stimulating factors remain the most commonly used mobilization agents. Currently, chemotherapy or plerixafor in combination with G-CSF is a reasonable option in heavily pretreated and hard-to-mobilize patients with non-Hodgkin's lymphoma and multiple myeloma.
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Affiliation(s)
- Lindsay L Rosenbeck
- Lindsay L Rosenbeck PharmD, PGY-2 Hematology/Oncology Pharmacy Resident, Department of Pharmacy, Simon Cancer Center-Clarian Health, Indiana University, Indianapolis, IN
| | - Shivani Srivastava
- Shivani Srivastava MD, Assistant Professor of Medicine, Department of Medicine, Bone Marrow and Stem Cell Transplantation, School of Medicine, Indiana University
| | - Patrick J Kiel
- Patrick J Kiel PharmD BCPS, Clinical Pharmacy Specialist, Hematology/Stem Cell Transplant, Simon Cancer Center-Clarian Health, Indiana University
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95
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Abstract
Pharmacological manipulation of CXCR4 has proven clinically useful for mobilization of stem and progenitor cells and in several preclinical models of disease. It is a key component in the localization of leukocytes and stem cells. For patients with multiple myeloma and non-Hodgkin's Lymphoma, treatment with plerixafor, an inhibitor of CXCL12 binding to CXCR4, plus G-CSF mobilizes stem cells for autologous transplantation to a greater degree than the treatment with G-CSF alone, and in some cases when patients could not be mobilized with cytokines, chemotherapy, or the combination. Stem cells from healthy donors mobilized with single agent plerixafor have been used for allogeneic transplantation in acute myelogenous leukemia (AML) patients, although this is still in the early phase of clinical development. Plerixafor is also undergoing evaluation to mobilize tumor cells in patients with AML and chronic lymphocytic leukemia (CLL) to enhance the effectiveness of chemotherapy regimens. Plerixafor's effect on neutrophils may also restore circulating neutrophil counts to normal levels in patients with chronic neutropenias such as in WHIMs syndrome. Other areas where inhibition of CXCR4 may be useful based upon preclinical or clinical data include peripheral vascular disease, autoimmune diseases such as rheumatoid arthritis, pulmonary inflammation, and HIV.
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96
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A Pharmacokinetic Study of Plerixafor in Subjects with Varying Degrees of Renal Impairment. Biol Blood Marrow Transplant 2010; 16:95-101. [DOI: 10.1016/j.bbmt.2009.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Accepted: 09/04/2009] [Indexed: 11/17/2022]
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97
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Neumann F, Zohren F, Haas R. The role of natalizumab in hematopoietic stem cell mobilization. Expert Opin Biol Ther 2009; 9:1099-106. [PMID: 19566481 DOI: 10.1517/14712590903055011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The humanized monoclonal very late antigen 4 (VLA-4) antibody natalizumab is FDA approved for the treatment of patients with multiple sclerosis and Crohn's disease. In this review we focus on its role in the context of hematopoietic stem cell transplantation and stem cell diseases. The use of natalizumab alone or in combination with either cytotoxic drugs or other antibodies might be a new modality for stem cell mobilization and a therapeutic option for patients with hematologic malignancies.
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Affiliation(s)
- Frank Neumann
- Heinrich-Heine-University, Department of Hematology, Oncology and Clinical Immunology, Duesseldorf, Germany.
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98
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99
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Seufferlein T, Ahn J, Krndija D, Lother U, Adler G, von Wichert G. Tumor biology and cancer therapy - an evolving relationship. Cell Commun Signal 2009; 7:19. [PMID: 19678929 PMCID: PMC2731766 DOI: 10.1186/1478-811x-7-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Accepted: 08/13/2009] [Indexed: 12/20/2022] Open
Abstract
The aim of palliative chemotherapy is to increase survival whilst maintaining maximum quality of life for the individual concerned. Although we are still continuing to explore the optimum use of traditional chemotherapy agents, the introduction of targeted therapies has significantly broadened the therapeutic options. Interestingly, the results from current trials put the underlying biological concept often into a new, less favorable perspective. Recent data suggested that altered pathways underlie cancer, and not just altered genes. Thus, an effective therapeutic agent will sometimes have to target downstream parts of a signaling pathway or physiological effects rather than individual genes. In addition, over the past few years increasing evidence has suggested that solid tumors represent a very heterogeneous group of cells with different susceptibility to cancer therapy. Thus, since therapeutic concepts and pathophysiological understanding are continuously evolving a combination of current concepts in tumor therapy and tumor biology is needed. This review aims to present current problems of cancer therapy by highlighting exemplary results from recent clinical trials with colorectal and pancreatic cancer patients and to discuss the current understanding of the underlying reasons.
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Affiliation(s)
- Thomas Seufferlein
- Department of Internal Medicine I, University of Ulm, Albert Einstein Allee 23, 89081 Ulm, Germany.
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100
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Abstract
The treatment of newly diagnosed myeloma has evolved rapidly. The choice of initial therapy depends on eligibility for stem cell transplantation, as well as baseline risk factors. Eligibility for transplantation is important since the choice of initial therapy is primarily melphalan-based in patients who are not candidates for transplant, while melphalan-containing regimens are avoided as induction therapy in transplant candidates. An assessment of risk based on independent prognostic markers is important mainly for prognosis but may have some value in choice of initial therapy. For example, bortezomib-based regimens may have particular value in patients with certain high-risk features. This review discusses the current status of front-line therapy in younger patients with myeloma who are candidates for stem cell transplantation.
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