Comparable efficacy and lower cost of PBSC mobilization with intermediate-dose cyclophosphamide and G-CSF compared with plerixafor and G-CSF in patients with multiple myeloma treated with novel therapies
Studies comparing the efficacy and cost of stem cell mobilization with intermediate-dose CY (ID-CY) and G-CSF against plerixafor and G-CSF, specifically in multiple myeloma (MM) patients treated in the novel therapy era, are not available. Eighty-eight consecutive patients undergoing mobilization wi...
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| Published in: | Bone marrow transplantation (Basingstoke) Vol. 48; no. 10; pp. 1279 - 1284 |
|---|---|
| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
Nature Publishing Group UK
01-10-2013
Nature Publishing Group |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Studies comparing the efficacy and cost of stem cell mobilization with intermediate-dose CY (ID-CY) and G-CSF against plerixafor and G-CSF, specifically in multiple myeloma (MM) patients treated in the novel therapy era, are not available. Eighty-eight consecutive patients undergoing mobilization with ID-CY (3–4 g/m
2
) and G-CSF (
n
=55) were compared with patients receiving plerixafor and G-CSF (
n
=33). Compared with plerixafor, ID-CY use was associated with higher median peak peripheral blood CD34+ cell count (68 vs 160 cells/μL,
P
<0.001), and CD34+ cell yield on day 1 of collection (6.9 × 10
6
vs 11.7 × 10
6
cells/kg,
P
<0.001). Total CD34+ cell yield was significantly higher in the ID-CY patients (median collection 16.6 × 10
6
vs 11.6 × 10
6
cells/kg;
P
<0.001). ID-CY use was associated with significantly more frequent episodes of febrile neutropenia (16.3% vs 0%;
P
=0.02), intravenous antibiotic use (16.3% vs 3%;
P
=0.03) and hospitalizations (
P
=0.02). The average total cost of mobilization in the plerixafor group was significantly higher compared with the ID-CY group ($28 980 vs $22 504.8;
P
=0.001). Our data indicate robust stem cell mobilization in MM patients treated with novel agents, with G-CSF and either ID-CY or plerixafor. When compared with plerixafor, ID-CY-containing mobilization was associated with significantly lower average total mobilization costs. |
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| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| ISSN: | 0268-3369 1476-5365 |
| DOI: | 10.1038/bmt.2013.52 |