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

F. Awan, S. T. Kochuparambil, D. E. Falconer, A. Cumpston, S. Leadmon, K. Watkins, D. Deremer, A. Jillella, M. Craig, M. Hamadani

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

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, P<0.001), and CD34+ cell yield on day 1 of collection (6.9 × 10 6 vs 11.7 × 10 6 cells/kg, P<0.001). 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; P<0.001). 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.

Original languageEnglish (US)
Pages (from-to)1279-1284
Number of pages6
JournalBone Marrow Transplantation
Volume48
Issue number10
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

Keywords

  • CY
  • bortezomib
  • lenalidomide
  • mobilization
  • multiple myeloma
  • plerixafor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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