Mozobil, also known by its generic name plerixafor, is a specialized medication used in certain cancer treatments. Its primary purpose involves preparing patients for autologous stem cell transplantation. It helps move specific cells from the bone marrow into the bloodstream, making them available for collection.
How Mozobil Works
Mozobil functions by targeting a specific protein receptor found on the surface of hematopoietic stem cells, which are blood-forming cells. It acts as a CXCR4 antagonist, blocking the CXCR4 receptor. This receptor normally interacts with stromal cell-derived factor-1-alpha (SDF-1α), which anchors stem cells within the bone marrow.
By blocking this interaction, Mozobil disrupts the signals that keep these stem cells in the marrow. This disruption causes the hematopoietic stem cells to be released and move into the peripheral bloodstream. The drug’s effect is rapid, typically increasing circulating stem cell levels within hours of administration, and these effects are also reversible.
Conditions Treated with Mozobil
Mozobil is specifically approved for use in patients with certain blood cancers who are undergoing autologous stem cell transplantation. Its main indications include non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). For these conditions, high-dose chemotherapy is often used to eliminate cancer cells, but this treatment also destroys healthy blood-forming cells in the bone marrow. Autologous stem cell transplantation aims to replace these destroyed blood-forming cells with the patient’s own healthy stem cells that were collected before chemotherapy. It is not intended for stem cell mobilization in patients with leukemia.
Administering Mozobil and Common Effects
Mozobil is typically administered as a subcutaneous injection, meaning it is injected just under the skin. The usual dose is 0.24 mg per kilogram of body weight, given approximately 6 to 11 hours before the start of each stem cell collection procedure. This injection can be repeated for up to four consecutive days, depending on the patient’s needs and the number of stem cells collected.
Patients receiving Mozobil may experience several common side effects. These often include gastrointestinal issues such as diarrhea, nausea, and vomiting, as well as fatigue, headache, and dizziness. Injection site reactions, like redness or swelling, are also common. These effects are generally mild to moderate and may improve after the treatment course is completed.
The Role of Mozobil in Stem Cell Collection
It is used in conjunction with granulocyte-colony stimulating factor (G-CSF), another medication that stimulates the production and release of stem cells from the bone marrow. G-CSF is typically given daily for several days before Mozobil is introduced.
The sequence usually involves a patient receiving chemotherapy, followed by several days of G-CSF injections. Mozobil is then administered in the evening, approximately 10 to 11 hours before the apheresis procedure the next morning. Apheresis is a process where blood is drawn from the patient, stem cells are separated, and the remaining blood components are returned to the body. This combined approach with G-CSF and Mozobil helps to mobilize a sufficient number of stem cells into the bloodstream, making their collection more efficient.