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

S. Afifi, N. G. Adel, S. Devlin, E. Duck, J. Vanak, H. Landau, D. J. Chung, N. Lendvai, A. Lesokhin, N. Korde, L. Reich, O. Landgren, S. Giralt, H. Hassoun

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

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 ≥5 × 10 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.

Original languageEnglish (US)
Pages (from-to)546-552
Number of pages7
JournalBone Marrow Transplantation
Volume51
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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