plerixafor at a glance
Medicine class
CXCR4 receptor antagonist and stem-cell mobiliser
Main role
Improves collection of blood-forming stem cells when mobilisation is inadequate
Administration
Injection under the skin, usually given by a specialist hospital team
Used with
G-CSF and apheresis as part of a planned mobilisation procedure
What is plerixafor used for?
Licensed uses, always in combination with G-CSF, are:
Mobilising stem cells for collection and later autologous transplantation in adults with lymphoma or multiple myeloma whose cells mobilise poorly.
Mobilising stem cells in children aged 1 to under 18 with lymphoma or solid malignant tumours when collection is predicted to be inadequate or a previous collection was insufficient.
How does plerixafor work?
Plerixafor reversibly blocks CXCR4, a receptor involved in retaining stem cells within bone marrow through its interaction with CXCL12. This allows more CD34-positive stem and progenitor cells to enter the bloodstream for collection by apheresis.
plerixafor preparations and strengths
Injection
Route: Parenteral
Strengths: 20 mg/mL
How to take plerixafor
Plerixafor is injected under the skin by a doctor or nurse as part of a carefully timed hospital mobilisation and collection plan. It is supplied as a preservative-free, single-use solution; staff inspect it for particles or discolouration before administration.
Follow the transplant unit's appointment and blood-test instructions closely.
Tell staff promptly if you feel dizzy, light-headed or unwell after the injection.
Do not drive or operate machinery if dizziness, tiredness or faintness occurs.
plerixafor side effects
Common or expected effects
- Diarrhoea or nausea
- Injection-site redness, irritation or other local reaction
- Headache or dizziness
- Vomiting, abdominal discomfort, indigestion, constipation or wind
- Tiredness, feeling unwell or difficulty sleeping
- Joint, muscle or bone pain
- Sweating or skin redness
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty, facial or eye swelling, fainting or shock
- Pain under the left ribs or at the shoulder tip, which may indicate spleen enlargement or rupture
- Severe or persistent diarrhoea, vomiting, nausea or abdominal pain
- Chest discomfort
- Marked faintness, low blood pressure or loss of consciousness
plerixafor in pregnancy
Human pregnancy data are inadequate, and animal findings plus the medicine's mechanism suggest potential fetal harm. Plerixafor should generally not be used during pregnancy unless specialist assessment concludes that treatment is clinically required; effective contraception is required during treatment.
plerixafor while breastfeeding
It is unknown whether plerixafor passes into human milk, and risk to a breastfed child cannot be excluded. Breastfeeding should be stopped during treatment after discussion with the specialist team.
plerixafor interactions
Formal interaction studies are limited, so the clinical team should review all medicines before mobilisation.
G-CSF medicines
Plerixafor is licensed for use with G-CSF; together they increase circulating white cells and stem cells, requiring blood-count monitoring.
Rituximab
Clinical study data did not indicate an adverse effect on safety or stem-cell yield when rituximab was included in the mobilisation regimen.
Medicines metabolised through CYP450 enzymes
A clinically important metabolic interaction is considered unlikely because plerixafor neither uses nor substantially affects major CYP450 pathways in laboratory studies.
Common questions about plerixafor
Answers are fully visible for fast scanning and source review.
Why is plerixafor added to G-CSF?
It is added when G-CSF alone may not release enough stem cells into the blood for collection.
Is plerixafor chemotherapy?
No. It is a stem-cell mobiliser that helps move blood-forming stem cells from bone marrow into the bloodstream.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.