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Plerixafor Effectively Mobilizes CD56bright NK Cells in Blood Providing an Allograft Predicted to Protect Against GvHD

By May 21, 2018No Comments

The recent Blood article by Schroeder et al. demonstrates that plerixafor mobilizes a
unique hematopoietic stem and progenitor cell (HSPC) product that is enriched in plasmacytoid
dendritic cell precursors (pre-pDCs).

This study further reports that enrichment of these cells in
plerixafor-mobilized allografts is associated with lower cumulative incidence of acute and
chronic graft-versus-host disease (GvHD). In an earlier study, Waller et al. reports a protective
advantage against acute GvHD (aGvHD) of pDCs derived from bone marrow but not
granulocyte colony stimulating factor (G-CSF)-mobilized peripheral blood (PB) graft.

have shown that allogeneic transplantation with bone marrow (BM) allograft results in lower rate
of acute and chronic GvHD when compared to G-CSF-mobilized PB graft. In his commentary to
the Schroeder study, Waller proposes that the relatively rapid onset of mobilization by plerixafor
(hours vs. days by G-CSF) generates a novel PB graft that immunologically and phenotypically
resembles cells harvested from bone marrow.3
He hypothesizes that this unique allograft
contains immune subsets, including pre-pDCs and pDCs, which favorably modulate
alloreactivity post-transplantation thus resulting in lower GvHD rates.