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
| Autor: | Aaron Cumpston, Mehdi Hamadani, Michael Craig, F. T. Awan, Sonia Leadmon, Kathy Watkins, David L. DeRemer, Anand Jillella, Samith Thomas Kochuparambil, D E Falconer |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Benzylamines Cyclophosphamide Cyclams Heterocyclic Compounds Internal medicine Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor medicine Humans In patient Multiple myeloma Lenalidomide Aged Retrospective Studies Transplantation Peripheral Blood Stem Cell Transplantation Mobilization Bortezomib business.industry Plerixafor Hematology Middle Aged medicine.disease Hematopoietic Stem Cell Mobilization Surgery Lower cost Female business Multiple Myeloma medicine.drug |
| Zdroj: | Bone marrow transplantation. 48(10) |
| ISSN: | 1476-5365 |
| Popis: | 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, P0.001), and CD34+ cell yield on day 1 of collection (6.9 × 10(6) vs 11.7 × 10(6) cells/kg, P0.001). 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; P0.001). 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. |
| Databáze: | OpenAIRE |
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