Plerixafor and Sargramostim (GM-CSF) for Mobilization of Allogeneic Sibling Donors

Inclusion Criteria:

Donor Eligibility

• Donor is 18 to 65 years of age inclusive.
• If female and of child-bearing age, donor must be non-pregnant, not breastfeeding, and agree to use adequate contraception.
• Donor is a 6/6 HLA-matched sibling willing to donate PBSC for transplant.
• Donor has adequate cardiac function with no history of congestive heart failure and no history of atrial fibrillation or ventricular tachyarrhythmia.
• Donor has adequate renal function as defined by a calculated serum creatinine clearance of ≥56 ml/min for females and ≥64 ml/min for males.
• Donor has adequate hepatic function as defined by a total bilirubin <2x normal or absence of hepatic fibrosis/cirrhosis.
• Donor has adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality. No history of cerebrovascular accident or seizure disorder requiring anticonvulsant medication.
• Donor must be HIV-1&2 antibody and HTLV-I&II antibody sero-negative, by FDA licensed test.
• Donor must have an ECOG performance status of 0 or 1.
• Donor must demonstrate ability to be compliant with study regimen.
• Donor must not have an active infection at the time of study entry.
• Donor does not have active alcohol or substance abuse within 6 months of study entry.
• Donor is not currently enrolled on another investigational agent study.
• Donor does not have any medical condition, which, in the opinion of the clinical investigator, would interfere with his/her evaluation.
• Ability of the donor to understand and the willingness to sign a written informed consent document.

Recipient Eligibility

• Recipient must have available the successful collection of a GM-CSF + plerixafor mobilized product. When an adequate collection cannot be obtained, G-CSF will be used and some recipients may need to receive a combined product of mobilized cells with plerixafor + GM-CSF and G-CSF mobilized cells. Recipients who receive less than 2.0 X 106 CD34+ cells/kg/actual recipient weight after six days of GM-CSF and two days of IV plerixafor will not be considered "eligible" but followed per protocol for safety purposes only.
• Recipient is 18 to 65 years of age inclusive.
• Recipient is willing and has a 6/6 HLA-matched sibling willing to donate PBSC for transplant.
• Recipient must provide signed informed consent.
• If female and of child-bearing age, recipient must be non-pregnant, not breastfeeding, and using adequate contraception.
• Recipient must have one of the following diagnoses:
• Acute myelogenous leukemia (AML) in 1st or subsequent remission or in relapse,
• Acute lymphoblastic leukemia (ALL) in 1st or subsequent remission or in relapse,
• Myelodysplastic syndrome either intermediate 1 or 2, or high risk by the International Prognostic Scoring System,
• Chronic myelogenous leukemia (CML) in accelerated or second chronic phase,
• Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) in 2nd or greater complete remission, partial remission, or refractory relapse,
• Chronic lymphocytic leukemia (CLL), Rai Stage 2-4, failing at least 2 prior regimens, OR
• Multiple myeloma (MM), Stage 2-3.
• Myeloproliferative disorder or neoplasm
• Recipient must have adequate cardiac function with a left ventricular ejection fraction ≥ 40%.
• Recipient must have adequate pulmonary function defined as NO severe or symptomatic restrictive or obstructive lung disease, and formal pulmonary function testing showing an FEV1 ≥50% of predicted and a DLCO ≥40% of predicted, corrected for hemoglobin.
• Recipient must have adequate renal function as defined by a serum creatinine clearance of ≥75% of normal (Cockcroft-Gault equation).
• Recipient must have adequate hepatic function as defined by a total bilirubin <2x normal or absence of hepatic fibrosis/cirrhosis.
• Recipient must have adequate neurologic function as defined by NO evidence of a severe central or peripheral neurologic abnormality. Patients with a history of previous CNS tumor involvement are eligible provided they are without symptoms or signs and the CNS is now free of disease on lumbar puncture and CT scan of the brain.
• Recipient must have no evidence of active infection at the time of the transplant preparative regimen or at time of transplantation.
• Recipient must be HIV-1&2 antibody and HTLV-I & II antibody sero-negative, by FDA licensed test.
• Recipient has an ECOG performance status of 0 or 1.
• Recipient must demonstrate ability to be compliant with medical regimen.
• Recipient must not have active alcohol or substance abuse within 6 months of study entry.
• Recipient must not be enrolled on another investigational agent concurrently.
• Recipient must not have any medical condition, which, in the opinion of the clinical investigator, would interfere with the evaluation of the patient.
• Recipient must have a life expectancy of greater than 4 weeks.
• Both men and women and members of all races and ethnic groups are eligible for this trial.

Exclusion Criteria:

Donor Exclusion Criteria in addition to that stated above

• Donor may not be receiving any other investigational agents.
• Donor may not have a history of allergic reactions attributed to compounds of similar chemical or biologic composition to plerixafor or GM-CSF, or known hypersensitivity to yeast-derived products or any component of the product.