Comparison and cost analysis of three protocols for mobilization and apheresis of haematopoietic progenitor cells.

Journal of Clinical Apheresis
Francisco López-CastañoLuis Hernández

Abstract

Autologous bone marrow transplantation is a component of the malignant hemopathy therapy. The preferred mobilization and collection method is apheresis. The aim of this study is to compare three protocols analyzing the effect of plerixafor, higher dose of G-CSF and large volume leukapheresis (LVL). A retrospective cohort study including 119 patients referred for mobilization. Three protocols were compared: (a) G-CSF 10 μg/kg/day subcutaneous (sc) × 4 days mobilizing 1 to 1.5 blood volumes. (b) G-CSF 10 μg/kg/day sc × 4 days + plerixafor 0.24 mg/kg/day sc preventively or as a rescue agent mobilizing 1 to 1.5 blood volumes. (c) G-CSF 20 μg/kg/day sc × 4 days ± plerixafor 0.24 mg/kg/day sc preventively or as a rescue agent mobilizing 3 to 4 blood volumes. The average number of days of apheresis was reduced to 1.37 with protocol 3. The average cost per patient was reduced by 67% compared with protocol 2 and increased by only 5% compared with protocol 1, reducing the failure rate to 0%. Adding preemptive or rescue plerixafor (protocol 2) to G-CSF 10 μg/kg/day alone (protocol 1) did not improve the days of apheresis nor the number of CD34+ cells collected but had higher cost and failure rate. Using LVL, plerixafor and G-CSF 20 μg/kg/...Continue Reading

References

Mar 24, 2005·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Zdenka GasováZdenka Bhuyian-Ludvíková
Aug 4, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Zdenka GašováMarek Trněný
Aug 13, 2011·Blood·L Bik ToKirsten E Herbert
Nov 2, 2013·Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur̈ Transfusionsmedizin Und Immunham̈atologie·Andreas HumpeAndreas Günther
Sep 30, 2015·Journal of Clinical Apheresis·Antony P MartinRichard E Clark
Mar 13, 2016·Revista brasileira de hematologia e hemoterapia·Marco Aurélio Salvino, Jefferson Ruiz
Aug 4, 2016·Annals of Hematology·Ville VarmavuoEsa Jantunen
May 13, 2017·Annals of Transplantation : Quarterly of the Polish Transplantation Society·Krzysztof GawrońskiJarosław Wajs

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