Upfront plerixafor plus G-CSF versus cyclophosphamide plus G-CSF for stem cell mobilization in multiple myeloma: Efficacy and cost analysis study Journal Article


Authors: Afifi, S.; Adel, N. G.; Devlin, S.; Duck, E.; Vanak, J.; Landau, H.; Chung, D. J.; Lendvai, N.; Lesokhin, A.; Korde, N.; Reich, L.; Landgren, O.; Giralt, S.; Hassoun, H.
Article Title: Upfront plerixafor plus G-CSF versus cyclophosphamide plus G-CSF for stem cell mobilization in multiple myeloma: Efficacy and cost analysis study
Abstract: Cyclophosphamide plus G-CSF (C+G-CSF) is one of the most widely used stem cell (SC) mobilization regimens for patients with multiple myeloma (MM). Plerixafor plus G-CSF (P+G-CSF) has demonstrated superior SC mobilization efficacy when compared with G-CSF alone and has been shown to rescue patients who fail mobilization with G-CSF or C+G-CSF. Despite the proven efficacy of P+G-CSF in upfront SC mobilization, its use has been limited, mostly due to concerns of high price of the drug. However, a comprehensive comparison of the efficacy and cost effectiveness of SC mobilization using C+G-CSF versus P+G-CSF is not available. In this study, we compared 111 patients receiving C+G-CSF to 112 patients receiving P+G-CSF. The use of P+G-CSF was associated with a higher success rate of SC collection defined as >= 5x10(6) CD34+ cells/kg (94 versus 83%, P=0.013) and less toxicities. Thirteen patients in the C+G-CSF arm were hospitalized owing to complications while none in the P+G-CSF group. C+G-CSF was associated with higher financial burden as assessed using institutional-specific costs and charges (P<0.001) as well as using Medicare reimbursement rates (P=0.27). Higher rate of hospitalization, increased need for salvage mobilization, and increased G-CSF use account for these differences.
Keywords: chemotherapy; transplantation; growth-factor; non-hodgkins-lymphoma; colony-stimulating factor; amd3100; rescue; autologous; hematopoietic stem; lenalidomide therapy; adequate pbsc collection
Journal Title: Bone Marrow Transplantation
Volume: 51
Issue: 4
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2016-04-01
Start Page: 546
End Page: 552
Language: English
ACCESSION: WOS:000373360400013
DOI: 10.1038/bmt.2015.322
PROVIDER: wos
PUBMED: 26726942
Notes: Article -- Source: Wos
Altmetric Score
MSK Authors
  1. Sergio Andres Giralt
    516 Giralt
  2. Hani Hassoun
    146 Hassoun
  3. Heather Jolie Landau
    180 Landau
  4. Nikoletta Lendvai
    83 Lendvai
  5. Jill M Vanak
    14 Vanak
  6. Lilian M Reich
    70 Reich
  7. Alexander Meyer Lesokhin
    115 Lesokhin
  8. David Chung
    78 Chung
  9. Nelly G Adel
    41 Adel
  10. Elaine Duck
    8 Duck
  11. Sean McCarthy Devlin
    288 Devlin
  12. Salma H Afifi
    8 Afifi
  13. Carl Ola Landgren
    188 Landgren
  14. Neha Sanat Korde
    62 Korde