The effects of plerixafor on the hemostatic system in patients undergoing stem cell mobilization

Despite numerous reports on the procoagulant activities of G-CSF, the effect of plerixafor on the hemostatic system is not clearly understood. This study aims to evaluate the effects of plerixafor on the hemostatic system when used for autologous stem cell mobilization (ASCM) for poor mobilizers (PM) with lymphoma and multiple myeloma. Patients who were performed ASCM with plerixafor in combination with GCSF were prospectively enrolled. Cohort A included patients mobilized with G-CSF whereas Cohort B included patients mobilized with G-CSF + plerixafor. Blood samples were obtained before the mobilization regimen and just before apheresis. CBC, coagulation tests, CRP, protein C and S, vWF antigen, and factors VIII and XII were studied. Cohort A (n= 30) of which 9 received chemotherapy + G-CSF. Factor VIII, INR, vWF antigen, and CRP significantly increased after G-CSF compared to baseline. Decreases in protein C and S were significant (p<0.001; p=0.005). In cohort B (n=15) no significant changes were observed in coagulation parameters Factor levels, protein C and S before and after the plerixafor. Fibrinogen decreased slightly after plerixafor administration (4.2773±2.2125 vs. 3.6987±1.5062; p=0.02). remained unchanged. In conclusion the addition of plerixafor to G-CSF did not exert further significant procoagulant effects.