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, Anand Jillella, M. Craig, M. Hamadani

Research output: Contribution to journalArticle

27 Citations (Scopus)

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

Fingerprint

Granulocyte Colony-Stimulating Factor
Multiple Myeloma
Cyclophosphamide
Costs and Cost Analysis
Hematopoietic Stem Cell Mobilization
Therapeutics
Febrile Neutropenia
Blood Cell Count
JM 3100
Hospitalization
Anti-Bacterial Agents

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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

In: Bone marrow transplantation, Vol. 48, No. 10, 01.10.2013, p. 1279-1284.

Research output: Contribution to journalArticle

Awan, F. ; Kochuparambil, S. T. ; Falconer, D. E. ; Cumpston, A. ; Leadmon, S. ; Watkins, K. ; Deremer, D. ; Jillella, Anand ; Craig, M. ; Hamadani, M. / 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. In: Bone marrow transplantation. 2013 ; Vol. 48, No. 10. pp. 1279-1284.
@article{5ccd995845d240ca812fe4fe8743f343,
title = "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",
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.",
keywords = "CY, bortezomib, lenalidomide, mobilization, multiple myeloma, plerixafor",
author = "F. Awan and Kochuparambil, {S. T.} and Falconer, {D. E.} and A. Cumpston and S. Leadmon and K. Watkins and D. Deremer and Anand Jillella and M. Craig and M. Hamadani",
year = "2013",
month = "10",
day = "1",
doi = "10.1038/bmt.2013.52",
language = "English (US)",
volume = "48",
pages = "1279--1284",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "10",

}

TY - JOUR

T1 - 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

AU - Awan, F.

AU - Kochuparambil, S. T.

AU - Falconer, D. E.

AU - Cumpston, A.

AU - Leadmon, S.

AU - Watkins, K.

AU - Deremer, D.

AU - Jillella, Anand

AU - Craig, M.

AU - Hamadani, M.

PY - 2013/10/1

Y1 - 2013/10/1

N2 - 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.

AB - 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.

KW - CY

KW - bortezomib

KW - lenalidomide

KW - mobilization

KW - multiple myeloma

KW - plerixafor

UR - http://www.scopus.com/inward/record.url?scp=84885599846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885599846&partnerID=8YFLogxK

U2 - 10.1038/bmt.2013.52

DO - 10.1038/bmt.2013.52

M3 - Article

C2 - 23584435

AN - SCOPUS:84885599846

VL - 48

SP - 1279

EP - 1284

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 10

ER -