Clinical genitourinary cancer · 2026
Rescue Plerixafor-based Mobilization and Outcomes of Salvage High-dose Chemotherapy in Relapsed/Refractory Germ Cell Tumors: A Large Single-center Experience.
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Bleve Sara, Cursano Maria Concetta, Menna Cecilia, Gianni Caterina, Schepisi Giuseppe, Gallà Valentina, Casadei Chiara, Mangianti Serena, Baravelli Stefano, Augello Accursio Fabio, Lanza Francesco, Rosti Giovanni, Vascotto Ismaela Anna, De Giorgi Ugo
Аннотация
BACKGROUND: High-dose chemotherapy (HDCT) with autologous peripheral blood progenitor cell (PBPC) support represents a potentially curative treatment for patients with relapsed/refractory germ cell tumors (GCTs). Plerixafor has demonstrated efficacy in improving CD34+ cell mobilization in hematologic malignancies, whereas evidence in solid tumors remains limited. Herein, we report a retrospective single-center experience with plerixafor-based rescue mobilization regimens in relapsed/refractory GCT patients eligible for salvage HDCT.
PATIENTS AND METHODS: We retrospectively analyzed relapsed/refractory GCT patients treated at our Institution between September 2009 and August 2023 who underwent PBPC mobilization with plerixafor in combination with chemotherapy and granulocyte colony-stimulating factor. The primary endpoint was successful CD34+ cell collection. Secondary endpoints included number of leukapheresis procedures, feasibility of HDCT, and survival outcomes.
RESULTS: Twenty-two patients were included. All patients had poor-prognosis relapsed/refractory GCT and received a median of 2.5 prior treatment lines. Successful peripheral blood stem cell collection with plerixafor-based regimens was achieved in 19 of 22 patients (86%), with a median CD34+ collection of 4.9 × 106 cells/kg and a median of 2.3 leukapheresis procedures. Fifteen patients (68%) subsequently underwent HDCT; 8 patients completed all 3 planned HDCT cycles. After a median follow-up of 66.8 months, 7 of 15 patients (47%) remained continuously disease-free. Median time to neutrophil and platelet engraftment was 12.5 and 14.8 days, respectively.
CONCLUSION: Plerixafor-based rescue mobilization appears feasible and effective for CD34+ stem cell collection in heavily pretreated patients with relapsed/refractory GCTs. These findings support the role of plerixafor as a rescue mobilization strategy for these patients.
PATIENTS AND METHODS: We retrospectively analyzed relapsed/refractory GCT patients treated at our Institution between September 2009 and August 2023 who underwent PBPC mobilization with plerixafor in combination with chemotherapy and granulocyte colony-stimulating factor. The primary endpoint was successful CD34+ cell collection. Secondary endpoints included number of leukapheresis procedures, feasibility of HDCT, and survival outcomes.
RESULTS: Twenty-two patients were included. All patients had poor-prognosis relapsed/refractory GCT and received a median of 2.5 prior treatment lines. Successful peripheral blood stem cell collection with plerixafor-based regimens was achieved in 19 of 22 patients (86%), with a median CD34+ collection of 4.9 × 106 cells/kg and a median of 2.3 leukapheresis procedures. Fifteen patients (68%) subsequently underwent HDCT; 8 patients completed all 3 planned HDCT cycles. After a median follow-up of 66.8 months, 7 of 15 patients (47%) remained continuously disease-free. Median time to neutrophil and platelet engraftment was 12.5 and 14.8 days, respectively.
CONCLUSION: Plerixafor-based rescue mobilization appears feasible and effective for CD34+ stem cell collection in heavily pretreated patients with relapsed/refractory GCTs. These findings support the role of plerixafor as a rescue mobilization strategy for these patients.