CXCR4

Chr 2AD

C-X-C motif chemokine receptor 4

Also known as: CD184, D2S201E, FB22, HM89, HSY3RR, LCR1, LESTR, NPY3R

The protein is a seven-transmembrane chemokine receptor that binds CXCL12/SDF-1 and signals through G-protein coupled pathways to regulate cell migration, hematopoiesis, and vascular development. Mutations cause WHIM syndrome (warts, hypogammaglobulinemia, infections, and myelokathexis), a primary immunodeficiency affecting neutrophil trafficking and immune function. Inheritance is autosomal dominant.

GeneReviewsOMIMResearchSummary from RefSeq, OMIM, UniProt
DNmechanismADLOEUF 1.051 OMIM phenotype
Clinical SummaryCXCR4
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Gene-Disease Validity (ClinGen)
WHIM syndrome · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Low constraint (pLI 0.02) — loss-of-function variants are relatively tolerated in the population.
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Clinical Trials
10 active or recruiting trials — potential therapeutic options may be available
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GeneReview available — CXCR4
Authoritative clinical overview · Recommended first read
Open GeneReview ↗
Some data sources returned errors (1)

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Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
1.05LOEUF
pLI 0.018
Z-score 1.48
OE 0.46 (0.231.05)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
1.66Z-score
OE missense 0.66 (0.570.77)
123 obs / 186.8 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios
LoF OE0.46 (0.231.05)
00.351.4
Missense OE0.66 (0.570.77)
00.61.4
Synonymous OE0.79
01.21.6
LoF obs/exp: 4 / 8.7Missense obs/exp: 123 / 186.8Syn Z: 1.49
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveCXCR4-related warts, hypogammaglobulinaemia, infections and myelokathexis syndromeDNAD
DN
0.81top 10%
GOF
0.82top 10%
LOF
0.2386th %ile

This gene has evidence for multiple mechanisms of pathogenicity (gain-of-function, dominant-negative and loss-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to gain-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

GOFprediction above median · 1 literature citation
DNprediction above median · 1 literature citation
LOF1 literature citation

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Literature Evidence

DNMutant CXCR4 proteins were found to form functional heterodimers with wildtype CXCR4, which is consistent with a dominant-negative effect.PMID:18436740
GOFThus, CXCR4 (L329fs) appears to be a de novo autosomal dominant frame-shift gain-of-function mutation that like other carboxy-terminus mutations causes WHIM syndrome.PMID:27059040
LOFThus, CXCR4 haploinsufficiency likely significantly contributed to the selective repopulation of HSCs and the myeloid lineage from a single chromothriptic HSC in WHIM-09.PMID:31687976

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

CXCR4 · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

3D Protein StructureAlphaFold

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Mesothelioma

New Preclinical and Clinical Approaches to Mesothelioma

RECRUITING
NCT06536179Marco Emilio BianchiStarted 2024-07-25
Waldenstrom's DiseaseWaldenstrom Macroglobulinemia

Prognostic Value of Circulating Tumoral DNA After the First 6 Months of Treatment in Patients With Waldenström Macroglobulinemia

RECRUITING
NCT04893564Phase NACentre Hospitalier Universitaire, AmiensStarted 2022-05-16
bone marrow sampleblood sample
Acute Myeloid LeukemiaMeasurable Residual Disease

Motixafortide for MRD Sensitization in AML

NOT YET RECRUITING
NCT07392970Phase PHASE2Washington University School of MedicineStarted 2026-05-31
Motixafortide
Relapsed/Refractory T-lymphoblastic Leukemia/Lymphoma

U69-CART-Cells For R/R T-ALL

RECRUITING
NCT07350863Phase PHASE1The First Affiliated Hospital of Soochow UniversityStarted 2026-06-25
CXCR4 CCR9 CAR-T
Waldenström Macroglobulinemia (WM)

Ibrutinib Followed by BR (Bendamustine and Rituximab) as a Time-Limited Therapy for Waldenström Macroglobulinemia

NOT YET RECRUITING
NCT07169565Phase PHASE1Institute of Hematology & Blood Diseases Hospital, ChinaStarted 2025-09-01
IbrutinibBendamustineRituximab
Waldenstrom's DiseasePrognostic Index

Prognostic Analyses on a Validation Series of Patients With Waldenström's Disease

RECRUITING
NCT05911802French Innovative Leukemia OrganisationStarted 2023-08-11
Primary MyelofibrosisSecondary Myelofibrosis

Decitabine in Treating Patients With Myelofibrosis

ACTIVE NOT RECRUITING
NCT00095784Phase PHASE2National Cancer Institute (NCI)Started 2004-09-29
DecitabineLaboratory Biomarker Analysis
Coronary Disease

Genetic Polymorphism Associated With Coronary Heart Disease Susceptibility and Variability of Clopidogrel Response

ACTIVE NOT RECRUITING
NCT03373552Hôpital Universitaire Fattouma BourguibaStarted 2015-08-12
Platelet function assay
Gastric and Cardia Adenocarcinomas

Biomoleculars Markers of Sensitivity to Pre- and Post-operative Chemotherapy of Gastric and Cardia Adenocarcinomas: a Pilot Study

RECRUITING
NCT02491840Phase NAUniversity Hospital, Strasbourg, FranceStarted 2016-05
Biopsy
Multiple Myeloma

Relevance of [68Ga]Ga -PentixaFor-PET for Initial Staging and Therapeutic Evaluation of Multiple Myeloma

ACTIVE NOT RECRUITING
NCT04561492Phase PHASE2Nantes University HospitalStarted 2021-09-21
[68Ga]Ga-PentixaFor
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