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Stem Cell Procurement

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

Bone Marrow Transplantation volume 48, pages 1279–1284 (2013)Cite this article

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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/m2) 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 × 106 vs 11.7 × 106 cells/kg, P<0.001). Total CD34+ cell yield was significantly higher in the ID-CY patients (median collection 16.6 × 106 vs 11.6 × 106 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.

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Acknowledgements

This study was supported in part by Conquer Cancer Foundation of ASCO Career Development Award (to MH) and ASBMT New Investigator Award (to MH).

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Authors and Affiliations

  1. Section of Hematology and Oncology, Georgia Health Sciences Center, Augusta, GA, USA

    F Awan, S T Kochuparambil, D DeRemer & A Jillella

  2. Lipscomb University College of Pharmacy, Nashville, TN, USA

    D E Falconer

  3. Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, WV, USA

    A Cumpston, S Leadmon, K Watkins, M Craig & M Hamadani

  4. Myeloma and Lymphoma Service, West Virginia University, Morgantown, WV, USA

    A Cumpston, S Leadmon, M Craig & M Hamadani

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  1. F Awan
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  2. S T Kochuparambil
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  4. A Cumpston
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  5. S Leadmon
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  9. M Craig
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  10. M Hamadani
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Correspondence to M Hamadani.

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Awan, F., Kochuparambil, S., Falconer, D. et al. 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. Bone Marrow Transplant 48, 1279–1284 (2013). https://doi.org/10.1038/bmt.2013.52

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