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

Autor: Afifi S; Pharmacy Department, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Adel NG; Pharmacy Department, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Devlin S; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Duck E; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Finance, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Vanak J; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Finance, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Landau H; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Chung DJ; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Lendvai N; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Lesokhin A; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Korde N; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Reich L; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Landgren O; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Giralt S; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA., Hassoun H; Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Department of Medicine, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY, USA.; Weill Cornell Medical College, New York, NY, USA.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2016 Apr; Vol. 51 (4), pp. 546-52. Date of Electronic Publication: 2016 Jan 04.
DOI: 10.1038/bmt.2015.322
Abstrakt: 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.
Databáze: MEDLINE
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