Summary
- An important statement from a major stem cell transplant organisation will help collection centres use a beneficial drug that aids stem cell collection.
- The guidelines specify how the drug, plerixafor, is best used in healthy donors.
- This also opens up the possibility of future research into wider uses of plerixafor that could benefit both donors and patients by making stem cell collections easier and more efficient.
Plerixafor - helping to boost stem cell numbers
The World Marrow Donor Association (WMDA), working with Anthony Nolan clinicians, has released official guidelines on the use of plerixafor in healthy donors.
Plerixafor is a drug that has been used for decades in autologous transplantation (stem cell transplants where the patient’s own stem cells are used in their transplant). Plerixafor is a stem cell ‘mobiliser,’ which means it boosts the number of blood stem cells that move out of the bone marrow into the blood so they can be collected through apheresis.
For allogeneic transplants – where a healthy donor provides the stem cells for a transplant – the mobiliser used is the hormone G-CSF (granulocyte-colony stimulating factor). However, there are some cases where even with G-CSF, donors don’t produce enough stem cells for a transplant. This means donors sometimes need a further G-CSF injection and a second day of donation, which adds to the burden on the donor while also delaying the transplant.
Plerixafor works differently from G-CSF, but can be used together with G-CSF in healthy donors to further boost the number of stem cells in the blood. Collection centres have begun giving plerixafor to donors who don’t produce enough stem cells after G-CSF alone – but there has been a need for wider guidelines about its use.
This led to a dedicated WMDA working group to survey collection centres that have used plerixafor with their donors, and discuss specific recommendations for its safe use in healthy donors. They released an official publication summarising their findings, first-authored by Dr Tania Dexter, our senior medical officer. Dr Dexter presented these findings at the 2026 EBMT meeting in Madrid.
What the recommendations say
The team of medical experts determined that plerixafor could be safely given to healthy donors after G-CSF injections, where the donor was not producing as many blood stem cells as needed, or where not enough stem cells were collected after a first collection.
The authors also suggested that plerixafor could potentially be given to donors before G-CSF injections had begun – but only where it was possible to reliably estimate that the donor was likely to not produce enough blood stem cells from G-CSF injections alone. Work from Dr Tania Dexter aims to help us predict which donors might fall into that category.
Overall, the side effects from plerixafor were considered to be mild or moderate. Most of the time, any side effects were gone within a day and most donors reported being fully recovered within a month of donation.
What this means for donors
The publication of this statement means collection centres now have more guidance in how to use plerixafor. This could mean that more donors will now be offered plerixafor to help them produce enough stem cells for a successful donation.
This also encourages future research into plerixafor and its potential use in donors who are predicted to not produce enough stem cells from G-CSF alone. If research into this area is successful, it could mean many donors may be able to avoid having two day-donations, potentially making the donation experience easier and also providing more donations to patients on time. Read more about our work in this area.
It’s exciting to see this statement being shared with the wider community, hopefully encouraging collection centres to use plerixafor in cases where it could safely boost the number of blood stem cells available in the blood. We will continue to monitor the impact of these guidelines and the use of plerixafor, to ensure it continues to safely improve collection efficiency.
Dr Tania Dexter, senior medical officer
Full citation
Dexter T, Perera K, Trillos AM, Sojo JF, Ward J, Lachance S, Van Eerden E, Bengtsson M, Pollichieni S, Hsu YM, Mengling T, Rieping J, Anthias C, Bemis A, Cody M. World Marrow Donor Association Statement on the Use of Plerixafor in Healthy Donors. Transplant Cell Ther. 2026 Jan 23:S2666-6367(26)00056-4. doi: 10.1016/j.jtct.2026.01.021. Epub ahead of print. PMID: 41581832.