Table 2.

Recommendations for stem cell mobilization

Chemotherapy and growth factor recommendations
Chemotherapy mobilization  • Cyclophosphamide (1.5 g/m2) on days 1 and 2.
• Granulocyte colony-stimulating factor (5 μg/kg) daily on day +3 after initiation of cyclophosphamide and daily thereafter until mobilization procedure is complete, with dose rounded to the nearest vial size (eg, 300, 480, 600, 780, 900 μg). Monitor leukocyte count daily (platelet support if <10/µL).
When white blood cell count is ≥10/µL, check blood CD34 levels.
-If CD34 is ≥10/µL, begin apheresis.
-If CD34 is <10/µL, continue granulocyte colony-stimulating factor and measure CD34 daily. When CD34 is >10/μL, begin apheresis.
-If CD34 <10/μL and white blood cells are >1/μL for 3 days, start plerixafor. When CD34 is >10/μL, begin apheresis.
Growth factor–only mobilization
• Granulocyte colony-stimulating factor (10 μg/kg) every day (day +1) and daily thereafter until mobilization procedure is complete, with dose rounded to nearest vial size (eg, 600; 780; 900; 960; 1080; 1260; 1440). On day 4, measure CD34 levels.
-If the goal is to collect for 1 transplant and day 4 CD34 is <10/µL, begin plerixafor and collect cells the next morning.
-If the goal is to collect for >1 transplant and day 4 CD34 is <20/µL, begin plerixafor and collect cells the next morning.
Plerixafor dosing
Renal clearance ≥50 mL/min: 0.24 mg/kg
Renal clearance <50 mL/min: 0.16 mg/kg
Dose never exceeds 24 mg