ClinicalTrials.gg
CompletedNCT00967785Updated Sep 28, 2026

A Phase I Study of Mozobil in the Treatment of Patients With WHIMS

A Phase 1/2 interventional study of Mozobil (TM) in Leukopenia, Neutropenia and Infections, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 1 site in United States. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-28.

Primary conditionNeutropeniaRegistry: LeukopeniaReclassifiedWhy we changed it
Registry
Leukopenia — the first condition term the registry derived for this study.
ClinicalTrials.gg
Neutropenia
Why
  1. The study's listed conditions name Neutropenia, a narrower term within Leukopenia.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
14
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Background:

  • WHIMS (Warts, Hypogammaglobulinemia, Infections, and Myelokathexis Syndrome) is caused by various genetic changes that increase the activity of the chemokine receptor, CXCR4. Excessive function of this receptor causes mature neutrophils (part of the white blood cells) to be retained within the bone marrow rather than being released to the blood and is one of the causes of severe inherited neutropenia (low white blood counts). In neutropenia, the body is less able to fight off infection. Patients with WHIMS usually are at risk for skin, soft tissue, sinus, and lung infections, which can result in loss of hearing, teeth, and lung function.
  • Current treatment for WHIMS consists of regular injections of a white blood cell growth stimulating medication called granulocyte colony stimulating factor (G-CSF), and supplemental immunoglobulin (antibody). These therapies are expensive, nonspecific, have significant side effects and toxicities, and do not fully correct all problems, especially warts and cancers related to human papillomavirus (HPV).
  • A drug called Mozobil has been approved for use in combination with G-CSF to increase the number of stem cells that can be collected prior to bone marrow transplantation. Mozobil may offer a specific and well-tolerated new treatment for WHIMS and other syndromes characterized by neutropenia.

Objectives:

  • To evaluate whether Mozobil is safe and effective to treat neutropenia (low white blood cell count) in patients with WHIMS.
  • To determine an appropriate treatment dose of Mozobil, within currently approved dosage levels.

Eligibility:

- Individuals between 18 and 75 years of age who have been diagnosed with WHIMS and have a history of severe infections.

Design:

  • Potential participants will undergo a screening with a medical history, physical examination, questionnaire, heart and lung function scans, and blood and urine samples. Tests will also be done for hepatitis B and C virus, and human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS), as well as to check neutrophil function.
  • Patients who are being treated with G-CSF will stop injections for 2 days before being admitted to the National Institutes of Health (NIH) Clinical Center.
  • Patients may participate in a Dose Escalation study and receive increasing doses of Mozobil over 5 days of treatment until their white blood cell count improves sufficiently or the maximum approved dose is reached. Blood samples will be taken regularly throughout the treatment process. Patients will then receive an additional dose of Mozobil at the maximum approved dose or the dose sufficient to cause improvement, before restarting the G-CSF injections.
  • Patients may also participate in a long-term Chronic Dosing study and receive Mozobil once or twice a day for up to a maximum of 60 months.
Read the detailed description

Mozobil (TM) (plerixafor injection, Genzyme/Sanofi) is a Food and Drug Administration approved medication to mobilize CD34+ hematopoietic stem cells prior to apheresis and use in autologous transplantation in non-Hodgkin lymphoma and multiple myeloma when used in conjunction with granulocyte-colony stimulating factor (G-CSF). The drug s mechanism of action is the specific and reversible inhibition of the chemokine receptor, CXCR4, expressed on CD34+ cells and other leukocytes. This inhibition interferes with the binding of stromal cell derived factor-1 (SDF-1), which is constitutively expressed on bone marrow stromal cells and appears to cause direct and indirect cellular adhesive interactions. Severe congenital neutropenia is a rare inherited disorder in which the affected individuals develop chronic or cyclical neutropenia with circulating counts below 500 cells/microliter blood. This disorder may result from a variety of genetic defects in progenitor- or neutrophil-expressed genes such as elastase, CXCR4, G6PC3, etc. Myelokathexis is the abnormal retention of mature leukocytes in the bone marrow and is seen in some types of severe chronic neutropenia such as warts, hypogammaglobulinemia, infections, and myelokathexis syndrome (WHIMS). WHIMS is a rare primary immunodeficiency, which is known to be caused by mutations that enhance CXCR4 signaling. Our hypothesis is that Mozobil(TM) can be used safely to partially block CXCR4 and treat neutropenia resulting from myelokathexis at doses considerably lower than that being used for CD34+ cell mobilization. This new treatment could also improve other aspects of the disease such as frequent infections, warts, and hypogammaglobulinemia. To test this hypothesis, we propose this trial of Mozobil (TM) in adults with WHIMS, examining safety and absolute neutrophil count as the primary endpoint. Mozobil is injected subcutaneously and will be injected via syringes (up to 84 months) or via an infusion pump (pilot trial of up to 10 subjects for a 24-month period).

02

Conditions studied

  • Leukopenia
  • Neutropenia
  • Infections
  • Warts
  • Myelokathexis

Keywords

  • Neutropenia
  • Hypogammaglobulinemia
  • Myelokathexis
  • Warts
  • Immunodeficiency
03

In context

Neutropenia Reclassified

316 studies on the registry are indexed under Neutropenia; 42 are open to participants now.

This study's enrollment of 14 is below the median of 82 across 230 interventional studies indexed under Neutropenia.

Browse Neutropenia studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,446 studies on the registry; 179 are open to participants now.

Of its 405 completed or terminated interventional studies of FDA-regulated products, 302 (75%) have results posted.

Compared within Neutropenia, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Leukopenia. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

All of the following inclusion criteria must be met for a subject to be enrolled in this study:

  • Clinical diagnosis of WHIMS and documented severe infection
  • Must be greater than or equal to 18 and less than or equal to 75 years of age
  • Willingness to interrupt medications to raise the white count (WBC) such as G-CSF or GM-CSF for at least 2 days before and while on the study drug
  • Must not be pregnant or breastfeeding
  • Must have a personal physician
  • Must be willing to provide blood, plasma, serum, and DNA samples for storage
  • Subjects must agree not to become pregnant or to impregnate a female. If of , must agree to consistently use two types of throughout study participation. Acceptable forms of contraception include the following:

    1. Condoms, male or female, with or without a spermicide
    2. Diaphragm or cervical cap with spermicide
    3. Intrauterine device
    4. Contraceptive pills or patch, Norplant, Depo-Provera or other FDA-approved contraceptive method
    5. Male partner has previously undergone a vasectomy for which there is documentation of aspermatogenic sterility

Exclusion criteria

EXCLUSION CRITERIA:

If any of the following exclusion criteria are met, a subject will not be enrolled in this study:

  • Absence of a diagnosis of WHIMS
  • Patient is less than 18 years old
  • Absence of a documented history of severe infection
  • Neutropenia due to maturation defects in the myeloid lineage or that the PI feels is unlikely to benefit from this medication
  • Pregnant women or breastfeeding
  • History of serious cardiac arrhythmia or cardiac defects that make such more likely
  • Renal failure (calculated [CrCl] \<15 mL/min or requiring dialysis)
  • Signs or symptoms of active microbial infection at the time of study entry.
  • Any condition that, in the investigator s opinion, places the patient at undue risk by participating in the study
  • Unwillingness to undergo testing or procedures associated with this protocol
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
14 participants (actual)

Study arms

  • Active comparator
    Treatment Arm

    neutropenia and infections

    Drug: Mozobil (TM)

Interventions

  • twice daily subcutaneous injection or via continuous subcutaneous infusion

06

What researchers measure

Primary outcomes

  1. Safety

    No incident of grade 3/4 toxicities.

    Time frame: Duration of treatment, up to 7 years

  2. Increase ANC

    Average ANC \> 250 and \> twice baseline level.

    Time frame: Duration of treatment, up to 7 years.

Secondary outcomes

  1. reduced HPV lesions

    photographs demonstrating reduced warts, after extended period of treatment.

    Time frame: duration of treatnebt, up to 6 years.

  2. Increase Leucocytes

    statistically significant increase leucocyte after drug injection.

    Time frame: prior to and after study drug

07

Study locations

1 site
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
08

References and documents

Publications

  • McDermott DH, Majumdar S, Velez D, Cho E, Li Z, Gao JL, Grieco MC, Lawrence MG, Silva SL, Castelo-Soccio LA, Follmann D, Murphy PM. Continuous Infusion of the CXCR4 Antagonist Plerixafor for WHIM Syndrome. medRxiv [Preprint]. 2025 Apr 22:2025.04.19.25325865. doi: 10.1101/2025.04.19.25325865. PubMed 40330596 ↗
  • Broxmeyer HE. A WHIM satisfactorily addressed. Blood. 2014 Apr 10;123(15):2286-8. doi: 10.1182/blood-2014-02-557579. PubMed 24723677 ↗
  • McDermott DH, Liu Q, Velez D, Lopez L, Anaya-O'Brien S, Ulrick J, Kwatemaa N, Starling J, Fleisher TA, Priel DA, Merideth MA, Giuntoli RL, Evbuomwan MO, Littel P, Marquesen MM, Hilligoss D, DeCastro R, Grimes GJ, Hwang ST, Pittaluga S, Calvo KR, Stratton P, Cowen EW, Kuhns DB, Malech HL, Murphy PM. A phase 1 clinical trial of long-term, low-dose treatment of WHIM syndrome with the CXCR4 antagonist plerixafor. Blood. 2014 Apr 10;123(15):2308-16. doi: 10.1182/blood-2013-09-527226. Epub 2014 Feb 12. PubMed 24523241 ↗
  • McDermott DH, Liu Q, Ulrick J, Kwatemaa N, Anaya-O'Brien S, Penzak SR, Filho JO, Priel DA, Kelly C, Garofalo M, Littel P, Marquesen MM, Hilligoss D, Decastro R, Fleisher TA, Kuhns DB, Malech HL, Murphy PM. The CXCR4 antagonist plerixafor corrects panleukopenia in patients with WHIM syndrome. Blood. 2011 Nov 3;118(18):4957-62. doi: 10.1182/blood-2011-07-368084. Epub 2011 Sep 2. PubMed 21890643 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jan 2010 to primary completion in Jun 2026, 197 months.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 27, 2009
First posted
Aug 28, 2009
StartActual
Jan 6, 2010
Primary completionActual
Jun 25, 2026
CompletionActual
Jun 25, 2026
Last update
Sep 28, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00967785
Responsible party
Sponsor
First posted
Aug 28, 2009
Start date
Jan 6, 2010
Primary completion
Jun 25, 2026
Completion
Jun 25, 2026
Last update
Sep 28, 2026

Study contacts

David H McDermott, M.D.
principal investigator · National Institute of Allergy and Infectious Diseases (NIAID)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Plerixafor

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