Dose capping of plerixafor in patients weighing more than 100 kg at one vial led to successful mobilization outcomes and significant cost savings

Abstract

Dose capping plerixafor at 24 mg for patients more than 100 kg is a cost-effective strategy, which achieved comparable mobilization outcomes and reduced the total number of vials of plerixafor used by half.

Fifty years of BMT: risk stratification, donor matching, and stem cell collection for transplantation

“…Because plerixafor is supplied in 24 mg single-use vials, for allogeneic donors weighing above 100 kg, the dose can be capped at 24 mg, rather than using an additional vial. This dose-capping strategy has been shown to confer significant cost-savings and achieved comparable collection outcomes as administering uncapped doses in patients weighing >100 kg and collecting autologous PBSCs ( 96 ).…”

“…Plerixafor has been demonstrated to be effective and safe in healthy donors when administered as the sole mobilization in a single dose shortly before collection, favorable collection outcomes have been observed in multiple studies ( 97 – 100 ). However, at over $8,000 per single-use vial at most hospitals, based on contracted wholesale prices ( 96 ), the main factor limiting the routine use of plerixafor in donors is the cost. In general, the use of plerixafor in allogeneic stem cell donors is more practical as an add-on salvage agent when there is a need to quickly collect an adequate amount of stem cells in a donor with suboptimal mobilization, whether due to the medical urgency of a conditioned recipient waiting for transplant, or limited donor availability or risk tolerance for further apheresis or bone marrow collection.…”