***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: In Europe , the combination of plerixafor + granulocyte colony-stimulating factor is approved for the mobilization of hematopoietic stem cells for autologous transplantation in patients with lymphoma and myeloma whose cells mobilize poorly . The purpose of this study was to further assess the safety and efficacy of plerixafor + granulocyte colony-stimulating factor for front-line mobilization in European patients with lymphoma or myeloma . In this multicenter , open label , single-arm study , patients received granulocyte colony-stimulating factor ( 10 μg/kg/day ) subcutaneously for 4 days ; on the evening of day 4 they were given plerixafor ( 0.24 mg/kg ) subcutaneously . Patients underwent apheresis on day 5 after a morning dose of granulocyte colony-stimulating factor . The primary study objective was to confirm the safety of mobilization  with plerixafor . Secondary objectives included assessment of efficacy ( apheresis yield , time to engraftment ) . The combination of plerixafor + granulocyte colony-stimulating factor was used to mobilize hematopoietic stem cells in 118 patients ( 90 with myeloma , 25 with non-Hodgkin 's lymphoma , 3 with Hodgkin 's disease ) .  Treatment-emergent plerixafor-related adverse events were reported in 24 patients . Most adverse events occurred within 1 hour after injection , were grade 1 or 2 in severity and included gastrointestinal disorders or injection-site reactions . The minimum cell yield ( ≥2 × 106 CD34 + cells/kg ) was harvested in 98 % of patients with myeloma and in 80 % of those with non-Hodgkin 's lymphoma in a median of one apheresis . The optimum cell dose ( ≥5 × 106 CD34 + cells/kg for non-Hodgkin 's lymphoma or ≥6 × 106 CD34 + cells/kg for myeloma ) was harvested in 89 % of myeloma patients and 48 % of non-Hodgkin 's lymphoma patients . In this prospect i ve , multicenter European study , mobilization with plerixafor + granulocyte colony-stimulating factor allowed the majority of patients with myeloma or non-Hodgkin 's lymphoma to undergo transplantation with minimal toxicity , providing further data supporting the safety and efficacy of plerixafor + granulocyte colony-stimulating factor for front-line mobilization of hematopoietic stem cells in patients with non-Hodgkin 's lymphoma or myeloma The purpose of this report is to analyze long-term clinical outcomes of patients exposed to plerixafor plus granulocyte colony-stimulating factor ( G-CSF ) for stem cell mobilization . This was a study of patients with non-Hodgkin lymphoma ( NHL ; n = 167 ) and multiple myeloma ( MM ; n = 163 ) who were enrolled in the long-term follow-up of 2 pivotal phase III studies ( NCT00741325 and NCT00741780 ) of 240  µg/kg plerixafor plus 10 µg/kg G-CSF , or placebo plus 10 µg/kg G-CSF to mobilize and collect CD34 + cells for autologous hematopoietic stem cell transplantation . Overall survival ( OS ) and progression-free survival ( PFS ) were evaluated over a 5-year period following the first dose of plerixafor or placebo . The probability of OS was not significantly different in patients with NHL or MM treated with plerixafor or placebo ( NHL : 64 % ; 95 % confidence interval [ CI ] , 56 % to 71 % versus 56 % ; 95 % CI , 44 % to 67 % , respectively ; MM : 64 % ; 95 % CI , 54 % to 72 % versus 64 % ; 95 % CI , 53 % to 73 % , respectively ) . In addition , there was no statistically significant difference in the probability of PFS over 5 years between treatment groups in patients with NHL ( 50 % ; 95 % CI , 44 % to 67 % for plerixafor versus 43 % ; 95 % CI , 31 % to 54 % for placebo ) or those with MM ( 17 % ; 95 % CI , 10 % to 24 % for plerixafor versus 30 % ; 95 % CI , 21 % to 40 % for placebo ) . In this long-term follow-up study , the addition of plerixafor to G-CSF for stem cell mobilization did not affect 5-year survival in patients with NHL or patients with MM Plerixafor , a novel CXCR4 inhibitor , is effective in mobilizing PBSCs particularly when used in conjunction with G-CSF . In four cohorts , this pilot study explored the safety of plerixafor mobilization when incorporated into a conventional stem cell mobilization regimen of chemotherapy and G-CSF . Forty ( 26 multiple myeloma and 14 non-Hodgkin 's lymphoma ) patients were treated with plerixafor . Plerixafor was well tolerated and its addition to a chemo-mobilization regimen result ed in an increase in the peripheral blood CD34 + cells . The mean rate of increase in the peripheral blood CD34 + cells was 2.8 cells/μl/h pre- and 13.3 cells/μl/h post-plerixafor administration . Engraftment parameters were acceptable after myeloblative chemotherapy , with the median day for neutrophil and plt engraftment being day 11 ( range 8–20 days ) and day 13 ( range 7–77 days ) , respectively . The data obtained from the analysis of the cohorts suggest that plerixafor can safely be added to chemotherapy-based mobilization regimens and may accelerate the rate of increase in CD34 + cells on the second day of apheresis . Further studies are warranted to evaluate the effect of plerixafor in combination with chemomobilization on stem cell mobilization and collection on the first and subsequent days of apheresis , and its impact on re source utilization This phase 3 , multicenter , r and omized ( 1:1 ) , double-blind , placebo-controlled study evaluated the safety and efficacy of plerixafor with granulocyte colony-stimulating factor ( G-CSF ) in mobilizing hematopoietic stem cells in patients with multiple myeloma . Patients received G-CSF ( 10 microg/kg ) subcutaneously daily for up to 8 days . Beginning on day 4 and continuing daily for up to 4 days , patients received either plerixafor ( 240 microg/kg ) or placebo subcutaneously . Starting on day 5 , patients began daily apheresis for up to 4 days or until more than or equal to 6 x 10(6 ) CD34(+ ) cells/kg were collected . The primary endpoint was the percentage of patients who collected more than or equal to 6 x 10(6 ) CD34(+ ) cells/kg in less than or equal to 2 aphereses . A total of 106 of 148 ( 71.6 % ) patients in the plerixafor group and 53 of 154 ( 34.4 % ) patients in the placebo group met the primary endpoint ( P < .001 ) . A total of 54 % of plerixafor-treated patients reached target after one apheresis , whereas 56 % of the placebo-treated patients required 4 aphereses to reach target . The most common adverse events related to plerixafor were gastrointestinal disorders and injection site reactions .  Plerixafor and G-CSF were well tolerated , and significantly more patients collected the optimal CD34(+ ) cell/kg target for transplantation earlier compared with G-CSF alone . This study is registered at www . clinical trials.gov as # NCT00103662 Hematopoietic progenitor cells ( HPCs ) traffic to and are retained in the marrow through the trophic effects of the chemokine stromal cell-derived factor-1alpha ( SDF-1alpha ) binding to its receptor , CXC chemokine receptor 4 ( CXCR4 ) . AMD3100 reversibly inhibits SDF-1alpha/CXCR4 binding , and AMD3100 administration mobilizes CD34(+ ) cells into the circulation . We therefore tested the hypotheses that the combination of AMD3100 plus granulocyte colony-stimulating factor ( G-CSF ) ( hereafter A + G ) would be superior to G-CSF alone ( hereafter G ) in mobilizing hematopoietic progenitor cells ( HPCs ) and that A + G-mobilized cells would engraft as well as G-mobilized cells . The primary objective was to determine whether patients mobilized more progenitor cells per unit of blood volume of apheresis after A + G administration versus G alone . Secondary objectives were to determine whether patients mobilized with A + G compared with G alone required fewer apheresis procedures to reach the target level at least 5 x 10(6 ) CD34(+ ) cells/kg for transplantation and to determine whether patients mobilized with A + G had at least a 90 % success rate of autologous transplantation as assessed by neutrophil engraftment by day 21 . Each patient served as his or her own control in a sequential mobilization design . All study objectives were met without significant toxicity . The results demonstrate that the combination of A + G is generally safe , effective , and superior to G alone for autologous HPC mobilization Purpose : On December 15 , 2008 , the US Food and Drug Administration approved plerixafor ( Mozobil ® ; Genzyme Corp. ) , a new small-molecule inhibitor of the CXCR4 chemokine receptor , for use in combination with granulocyte colony-stimulating factor ( G-CSF ) to mobilize hematopoietic stem cells ( HSC ) to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin ’s lymphoma ( NHL ) and multiple myeloma ( MM ) . This summary review s the data base supporting this approval . Experimental Design : The safety and efficacy of plerixafor were demonstrated by 2 multicenter , r and omized , placebo-controlled studies in patients with NHL and MM who were eligible for autologous HSC transplantation . The primary efficacy end points were the collection of ≧5 × 106 CD34 + cells/kg from the peripheral blood in 4 or fewer apheresis sessions in patients with NHL or ≧6 × 106 CD34 + cells/kg from the peripheral blood in 2 or fewer apheresis sessions in patients with MM . Results : The 2 r and omized studies combined enrolled 600 patients ( 298 with NHL and 302 with MM ) . Fifty-nine percent of patients with NHL who were mobilized with G-CSF and plerixafor had peripheral blood HSC collection s of ≧5 × 106 CD34 + cells/kg in 4 or fewer apheresis sessions , compared with 20 % of patients with NHL who were mobilized with G-CSF and placebo ( p < 0.001 ) . Seventy-two percent of patients with MM who were mobilized with Mozobil and G-CSF had peripheral blood HSC collection s of ≧6 × 106 CD34 + cells/kg in 2 or fewer apheresis sessions , compared with 34 % of patients with MM who were mobilized with placebo and G-CSF ( p < 0.001 ) . Common adverse reactions included diarrhea , nausea , vomiting , flatulence , injection site reactions , fatigue , arthralgia , headache , dizziness , and insomnia . Conclusions : This report describes the Food and Drug Administration review supporting the approval of plerixafor To evaluate the efficacy and safety of plerixafor for the mobilization/ collection of peripheral hematopoietic stem cells ( HSCs ) for autologous transplantation in Japanese patients with multiple myeloma ( MM ) . In a r and omized study , patients received G-CSF ( filgrastim , 400 µg/m2/day ) for 4 days prior to the first dose of plerixafor . Starting on Day 4 evening and for up to 4 days , patients received either plerixafor ( 240 µg/kg/day ) + G-CSF group ( PG group ) or G-CSF alone ( G group ) . Daily apheresis started on Day 5 for up to 4 days , or until ≥6 × 106 CD34 + cells/kg were collected . A total of 7 patients were r and omized in each treatment group . Five patients in PG group and no patients in G group achieved a collection of ≥6 × 106 CD34 + cells/kg in ≤2 days of apheresis [ difference of 71.4 % ( 90%CI 29–100 % ) ] . These results were supported by the shorter median time to collect ≥6 × 106 CD34 + cells/kg ( 2 days in PG group ; no patient in G group ) . The incidence of treatment emergent adverse events ( TEAEs ) was higher in PG group than in G group . Plerixafor was well tolerated , and effective for the mobilization/ collection of peripheral HSCs for autologous transplantation in Japanese patients with MM PURPOSE This study evaluates the safety and efficacy of plerixafor ( AMD3100 ) , a CXCR4 antagonist , in mobilizing hematopoietic stem cells for autologous stem-cell transplantation in non-Hodgkin 's lymphoma ( NHL ) patients . PATIENTS AND METHODS This is a phase III , 
    Output:
    
On the whole , the findings of this study indicate that the addition of plerixafor to G-CSF leads to an increased HSC collection in a shorter period of time with no concomitant increase in adverse events .