Plerixafor — Drug Monograph

Brand names: Mozobil

Drug class: Supportive Care Agent

Mechanism of Action

Reversibly inhibits the binding of stromal cell-derived factor-1 alpha (SDF-1 alpha / CXCL12) to the CXCR4 chemokine receptor. Blocking this anchor disrupts the tethering of CD34+ hematopoietic stem cells to the bone marrow stroma, resulting in rapid leukocytosis and release of stem cells into peripheral circulation.

FDA Indications

• In combination with granulocyte-colony stimulating factor (G-CSF) to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin lymphoma (NHL) or multiple myeloma (MM)

Common Side Effects

• Diarrhea
• Nausea
• Injection site reactions (erythema, swelling)
• Fatigue
• Headache
• Dizziness

Clinical Pearl

A reversible CXCR4 chemokine receptor antagonist used in combination with G-CSF (filgrastim) to mobilize hematopoietic stem cells into peripheral blood for autologous collection in NHL and multiple myeloma. CRITICAL TIMING: inject SC approximately 11 hours prior to the initiation of each apheresis session (typically given in the evening following morning G-CSF). Requires a one-third dose reduction in renal impairment (CrCl ≤ 50 mL/min). Fits the autologous-transplant mobilization step…

Related Therapies & Mechanisms

• Motixafortide (Aphexda) — Supportive Care Agent · Myeloma
• Rasburicase (Elitek) — Supportive Care Agent · Supportive Care
• Avatrombopag (Doptelet) — Supportive Care Agent · Supportive Care
• Defibrotide (Defitelio) — Supportive Care Agent · Supportive Care