G-CSF plus preemptive plerixafor vs hyperfractionated CY plus G-CSF for autologous stem cell mobilization in multiple myeloma: effectiveness, safety and cost analysis.

Bone Marrow Transplantation
A AntarA Bazarbachi

Abstract

The optimal stem cell mobilization regimen for patients with multiple myeloma (MM) remains undefined. We retrospectively compared our experience in hematopoietic cell mobilization in 83 MM patients using fractionated high-dose CY and G-CSF with G-CSF plus preemptive plerixafor. All patients in the CY group (n=56) received fractionated high-dose CY (5 g/m(2) divided into five doses of 1 g/m(2) every 3 h) with G-CSF. All patients in the plerixafor group (n=27) received G-CSF and plerixafor preemptively based on an established algorithm. Compared with plerixafor, CY use was associated with higher total CD34+ cell yield (7.5 × 10(6) vs 15.5 × 10(6) cells/kg, P=0.005). All patients in both groups yielded ⩾4 × 10(6) CD34+ cells/kg. Conversely, CY use was associated with high frequency of febrile neutropenia, blood and platelet transfusions need and hospitalizations. The average total cost of mobilization in Lebanon was slightly higher in the plerixafor group ($7886 vs $7536; P=0.16). Our data indicate robust stem cell mobilization in MM patients with either fractionated high-dose CY and G-CSF or G-CSF alone with preemptive plerixafor. The chemo-mobilization approach was associated with twofold stem cell yield, slightly lower cost but...Continue Reading

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Citations

Sep 30, 2015·Journal of Clinical Apheresis·Antony P MartinRichard E Clark
Apr 27, 2016·Hematology/oncology Clinics of North America·Yen-Michael S Hsu, Melissa M Cushing
Aug 4, 2016·Annals of Hematology·Ville VarmavuoEsa Jantunen
Aug 20, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Hien D Liu
Nov 5, 2016·Journal of Cancer Research and Clinical Oncology·Nils WinkelmannSebastian Scholl
Mar 1, 2019·Journal of Clinical Apheresis·Francisco López-CastañoLuis Hernández
Dec 14, 2018·Journal of Global Health·Shadi SalehAbla Mehio Sibai

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