Cost saving, patient centered algorithm for progenitor cell mobilization for autologous hematopoietic cell transplantation.
Adult
Aged
Algorithms
Cost Savings
Female
Filgrastim
/ pharmacology
Granulocyte Colony-Stimulating Factor
Health Care Costs
Hematopoietic Stem Cell Mobilization
/ economics
Hematopoietic Stem Cell Transplantation
/ economics
Humans
Lymphoma, Non-Hodgkin
/ economics
Lymphoproliferative Disorders
/ economics
Male
Middle Aged
Prospective Studies
Risk
Stem Cells
/ chemistry
Transplantation, Autologous
Young Adult
autologous hematopoietic cell transplantation
plerixafor
progenitor cell mobilization
Journal
Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
23
02
2021
received:
09
07
2020
accepted:
26
02
2021
pubmed:
13
3
2021
medline:
27
1
2022
entrez:
12
3
2021
Statut:
ppublish
Résumé
Administration of plerixafor with granulocyte-colony stimulating factor (G-CSF) mobilizes CD34+ cells much more effectively than G-CSF alone, but cost generally limits plerixafor use to patients at high risk of insufficient CD34+ cell collection based on low peripheral blood (PB) CD34+ counts following 4 days of G-CSF. We analyzed costs associated with administering plerixafor to patients with higher day 4 CD34+ cell counts to decrease apheresis days and explored the use of a fixed split dose of plerixafor instead of weight-based dosing. We analyzed 235 patients with plasma cell disorders or non-Hodgkin's lymphoma who underwent progenitor cell mobilization and autologous hematopoietic cell transplantation (AHCT) between March 2014 and December 2017. Two hundred ten (89%) received G-CSF plus Plerixafor and 25 (11%) received G-CSF alone. Overall, 180 patients (77%) collected in 1 day, 53 (22%) in 2 days and 2 (1%) in 3 days. Based on our data, we present a probabilistic algorithm to identify patients likely to require more than one day of collection using G-CSF alone. CD34+ cell yield, ANC and platelet recovery were not significantly different between fixed and standard dose plerixafor. Plerixafor enabled collection in 1 day and with estimated savings of $5000, compared to patients who did not receive plerixafor and required collection for three days. While collection and processing costs and patient populations vary among institutions, our results suggest re-evaluation of current algorithms.
Substances chimiques
Granulocyte Colony-Stimulating Factor
143011-72-7
Filgrastim
PVI5M0M1GW
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
553-562Subventions
Organisme : Kerry & Simone Vickar Family Foundation
Organisme : Levine Foundation
Informations de copyright
© 2021 Wiley Periodicals LLC.
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