Stem Cell Mobilisation
The process of moving haematopoietic stem cells from bone marrow into the peripheral blood for collection and transplantation. Motixafortide blocks the CXCR4/CXCL12 axis that retains stem cells in marrow niches, enabling efficient collection for autologous transplant in multiple myeloma patients.
Technical Context
HSC mobilisation for autologous transplantation: patients with multiple myeloma, lymphoma, or other conditions undergo high-dose chemotherapy (which destroys bone marrow) followed by infusion of their own previously collected HSCs to reconstitute the blood system. Mobilisation protocol: motixafortide (single SC injection) + G-CSF (5 days) → apheresis collection of CD34+ HSCs from peripheral blood. Motixafortide's contribution: CXCR4 blockade releases HSCs from marrow niches within 4-6 hours (vs G-CSF alone which takes 4-5 days). The combination produces higher CD34+ cell yields, often achieving target collection in a single apheresis session (vs multiple sessions with G-CSF alone). The GENESIS Phase III trial demonstrated superior HSC mobilisation with motixafortide + G-CSF vs placebo + G-CSF. Sufficient CD34+ cell collection (target ≥6 × 10⁶ CD34+ cells/kg) enables successful engraftment after high-dose chemotherapy.