Higher BMI is not a barrier to stem cell mobilization with standard doses of plerixafor and G-CSF

Overweight and obesity are growing epidemiologic problems worldwide. Body mass index (BMI) defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2) is a simple measure in common use. According to the WHO definition, people with a BMI X25 kg/m2 are overweight and those with a BMIX30 kg/m2 are obese. A raised BMI is recognized as a major risk factor for cardiovascular diseases, diabetes and musculoskeletal disorders, and also for a number of cancers, including non-Hodgkin’s lymphoma and multiple myeloma.This, taken together with higher doses of plerixafor in overweight and obese patients, may contribute to the increased cost of the mobilization procedure. However, as it is not known how the excess of fatty tissue affects the distribution of the drug, as well as homing and engraftment of mobilized progenitor cells, this problem could be potentially overcome by calculating the dose of plerixafor and/or required dose of hematopoietic stem cells per kg of ideal body weight and not per kg of actual body weight in overweight and obese individuals