[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Myeloid colony-stimulating factors](https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/) › Plerixafor

# Plerixafor

## Myeloid colony-stimulating factors?

Myeloid colony-stimulating factors

A CXCR4 blocker that, added to G-CSF, frees blood stem cells from the marrow for collection before an autologous transplant.

Updated Nov 1, 2026

## Quick facts

**Group**
[Myeloid colony-stimulating factors](https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/)

**Target**
Chemokine receptor CXCR4 on haematopoietic stem cells

**Used for**
Stem cell mobilisation · Stem cell mobilisation

**Key effects**
Diarrhoea · Injection-site reactions · Headache

**Monitor**
White cell and platelet counts · Kidney function

**ATC**
L03AX16

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Chemokine receptor CXCR4 on haematopoietic stem cells**Plerixafor

ⓘ The figure shows plerixafor bound to the human CXCR4 receptor (cryo-EM); the nanobody used to stabilise it is not part of the receptor.

**Target in 3D:** Chemokine receptor CXCR4 on haematopoietic stem cells. PDB structure 8ZPN (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8ZPN) · Drag to rotate · pinch to zoom

Stem cells stay in the marrow because CXCR4 on their surface binds the chemokine SDF-1α (CXCL12) made by marrow stromal cells. Plerixafor, a bicyclam molecule first developed against HIV, blocks CXCR4 so the cells lose their anchor and move into the blood, where they are collected by apheresis. It is a mobiliser, not a growth factor.

- SDF-1α (CXCL12) holds stem cells in the marrow through CXCR4
- Plerixafor blocks CXCR4
- Stem cells (CD34+) leave the marrow for the blood
- They are collected by apheresis for transplant

## Indications

- Stem cell mobilisation with G-CSF before autologous transplant in non-Hodgkin lymphoma [Non-Hodgkin lymphoma →](https://durgical.com/en/conditions/non-hodgkin-lymphoma/)
- Stem cell mobilisation with G-CSF before autologous transplant in multiple myeloma [Multiple myeloma →](https://durgical.com/en/conditions/multiple-myeloma/)

## Adverse effects

### Common

- Diarrhoea, nausea, vomiting, abdominal pain, gas
- Injection-site reactions
- Headache, dizziness, tiredness
- Joint pain, trouble sleeping

### Serious (rare, important)

- Anaphylaxis and serious hypersensitivity
- Enlarged or ruptured spleen (left upper abdominal or shoulder pain)
- Raised white cell count and low platelets

## Contraindications

- Previous hypersensitivity to plerixafor
- Not used to mobilise stem cells in leukaemia (it may also mobilise leukaemic cells)

## Key interactions

**Filgrastim or another G-CSF**
Combined on purpose: G-CSF is given first and continued while plerixafor is added

## What is monitored

- White cell and platelet counts
- Kidney function (the dose is reduced in renal impairment)
- Abdominal or shoulder pain suggesting splenic enlargement
- Hypersensitivity during and after the injection

## Administration and safety

- Subcutaneous injection by a health professional, timed some hours before each apheresis session
- Given only after several days of G-CSF
- Observe for hypersensitivity after each dose

## Pregnancy and breastfeeding

It can harm the fetus: effective contraception is used during treatment, and breastfeeding is avoided during treatment and for one week after the last dose.

## Nursing care

- Check the white count, platelets and creatinine before dosing
- Coordinate timing with the apheresis unit
- Teach to report left upper abdominal or shoulder pain at once
- Check pregnancy status and contraception

## Pharmacokinetics

**Absorption**
Subcutaneous injection

**Elimination**
Mainly by the kidneys; about 70% excreted unchanged in urine within 24 hours

**Half-life**
About 3–5 hours

## Memory aid

«PLERIXAFOR cuts the anchor»: CXCR4 holds stem cells home; cut it and they float into the blood.

## Test yourself

Think of the answer, then tap the question to see it.

## Which receptor does plerixafor block?

CXCR4, the receptor for SDF-1α (CXCL12).

## Which drug is it combined with?

A G-CSF such as filgrastim.

## In which disease is it not used for mobilisation, and why?

Leukaemia, because it may mobilise leukaemic cells too.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/plerixafor/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 2

- [Filgrastim](https://durgical.com/en/pharmacology/filgrastim/)
- [Pegfilgrastim](https://durgical.com/en/pharmacology/pegfilgrastim/)

## Related conditions 2

- [Non-Hodgkin lymphoma](https://durgical.com/en/conditions/non-hodgkin-lymphoma/)
- [Multiple myeloma](https://durgical.com/en/conditions/multiple-myeloma/)

[← Back to the class: Myeloid colony-stimulating factors](https://durgical.com/en/pharmacology/classes/myeloid-colony-stimulating-factors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - PLERIXAFOR injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d3f32914-4be5-4455-a3db-36c652051cf5) (DailyMed (U.S. National Library of Medicine), 2026); [Plerixafor Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a609018.html) (MedlinePlus (U.S. National Library of Medicine), 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/plerixafor/