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Journal of Clinical Oncology, Vol 22, No 6 (March 15), 2004: pp. 1095-1102
© 2004 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2004.07.131
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Rapid Mobilization of CD34+ Cells Following Administration of the CXCR4 Antagonist AMD3100 to Patients With Multiple Myeloma and Non-Hodgkin's Lymphoma

Steven M. Devine, Neal Flomenberg, David H. Vesole, Jane Liesveld, Daniel Weisdorf, Karin Badel, Gary Calandra, John F. DiPersio

From the Washington University School of Medicine, St Louis, MO; Thomas Jefferson University, Philadelphia, PA; Medical College of Wisconsin, Milwaukee, WI; University of Rochester, Rochester, NY; University of Minnesota, Minneapolis, MN; and AnorMed Inc, Langley, British Columbia, Canada.

Address reprint requests to Steven M. Devine, MD, 660 S Euclid Ave, Campus Box 8007, St Louis, MO 63110; e-mail: sdevine{at}im.wustl.edu

PURPOSE: Interactions between the chemokine receptor CXCR4 and its ligand stromal derived factor-1 regulate hematopoietic stem-cell trafficking. AMD3100 is a CXCR4 antagonist that induces rapid mobilization of CD34+ cells in healthy volunteers. We performed a phase I study assessing the safety and clinical effects of AMD3100 in patients with multiple myeloma (MM) and non-Hodgkin's lymphoma (NHL).

PATIENTS AND METHODS: Thirteen patients (MM, n = 7; NHL, n = 6) received AMD3100 at a dose of either 160 µg/kg (n = 6) or 240 µg/kg (n = 7). WBC and peripheral blood (PB) CD34+ cell counts were analyzed at 4 and 6 hours following injection.

RESULTS: AMD3100 caused a rapid and statistically significant increase in the total WBC and PB CD34+ counts at both 4 and 6 hours following a single injection. The absolute CD34+ cell count increased from a baseline of 2.6 ± 0.7/µL (mean ± SE) to 15.6 ± 3.9/µL and 16.2 ± 4.3/µL at 4 hours (P = .002) and 6 hours after injection (P = .003), respectively. The absolute CD34+ cell counts observed at 4 and 6 hours following AMD3100 were higher in the 240 µg/kg group (19.3 ± 6.9/µL and 20.4 ± 7.6/µL, respectively) compared with the 160 µg/kg group (11.3 ± 2.7/µL and 11.3 ± 2.5/µL, respectively). The drug was well tolerated and only grade 1 toxicities were encountered.

CONCLUSION: AMD3100 appears to be a safe and effective agent for the rapid mobilization of CD34+ cells in patients who have received prior chemotherapy. Further studies in combination with granulocyte colony-stimuating factor in patients with lymphoid malignancies are warranted.

Research support provided by Anormed, Inc, Langley, British Columbia.

Presented in part at the 8th Annual European Hematology Association Meeting, Lyon, France, June 14, 2003

Authors' disclosures of potential conflicts of interest are found at the end of this article.


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