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説明

Autologous hematopoietic stem cell (HSC) transplantation, a standard treatment for hematological malignancies, such as non-Hodgkin’s lymphoma or multiple myeloma, involves collection of HSCs from the patient, chemo- or radiotherapy of the patient to eliminate malignant cells, and retransplantation of the stored HSCs.
Plerixafor is a potent antagonist of the CXCR4 chemokine receptor and a first-in-class drug for stem cell mobilization. CXCR4 is specific for stromal-derived-factor-1 (SDF-1), a molecule endowed with potent chemotactic activity forlymphocytes. Because the interaction between SDF-1 and CXCR4 plays an important role in holding HSCs in the bone marrow, drugs that block the activity of CXCR4 receptor are capable of mobilizing HSCs into the bloodstream. In vitro, plerixafor potently blocks SDF-1 binding of CXCR4 and inhibits SDF-1-induced calcium flux (IC₅₀ = 0.01-0.13 mg/mL) and chemotaxis (IC₅₀ = 0.13 mg/mL) in several different cell types. Plerixafor, in combination with G-CSF, is specifically indicated to mobilize HSCs to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin’s lymphoma and multiple myeloma.