Plerixafor in poor mobilizers with non-Hodgkin’s lymphoma: a multi-center time-motion analysis

Abstract

High-dose chemotherapy alongside peripheral blood stem cell (PBSC) infusion has become the standard of care in different hematologic malignancies. The goal of PBSC mobilization is to allow collection of sufficient CD34+ cells to proceed to transplantation. The current mobilization regimen with granulocyte colony-stimulating factor (G-CSF), alone or in combination with chemotherapy, still fails in 10-25% of patients. Plerixafor is able to rescue most of these patients from mobilization failure. In this study, we investigated the impact of plerixafor on the cost and time spent on apheresis in patients who were considered poor mobilizers, with <20 × 10/µl peripheral CD34+ cells after mobilization but prior to apheresis. Patient hospital records from ten centers in three European countries were reviewed and compared during two time periods, namely prior and after plerixafor introduction to the market. During the plerixafor period, patients spent less time on apheresis (350 vs. 461 min). Poor mobilizers given plerixafor collected more CD34+ cells during the first apheresis session, leading to a decrease in the average number of apheresis sessions needed. The total apheresis yield was unaffected. This analysis shows that the use of plerixafor lessens the time-effort associated with the management of poor mobilizers and reduces apheresis costs.

Plerixafor combined with standard regimens for hematopoietic stem cell mobilization in pediatric patients with solid tumors eligible for autologous transplants: two-arm phase I/II study (MOZAIC)

“…The CI of the difference is based on the Wald asymptotic CI with continuity correction method. In adults, plerixafor has been observed to be advantageous in patients considered to be poor mobilizers using the current consensus threshold for poor mobilization in adults (<20 CD34+ cells/µL) [5][6][7]. However, the adult "consensus" threshold for poor mobilization may not be appropriate in the pediatric setting [8].…”

Comparison of filgrastim, pegfilgrastim, and lipegfilgrastim added to chemotherapy for mobilization of CD34+ cells in non‐Hodgkin lymphoma patients

“…Furthermore, the advantages of LIPEG use in the mobilization setting compared with FIL, despite similar total apheresis yields, include a single administration and lower laboratory costs as a consequence of fewer apheresis sessions that obviously compensates the lower costs of biosimilar filgrastim (Table ). In addition, plerixafor, which may also reduce the time spent on apheresis, was needed in only 13% of the patients in the LIPEG group. Further, early hematologic recovery appeared to be faster in the LIPEG group, and there was also a trend for a shorter hospitalization period during auto‐SCT compared with the other groups, making this G‐CSF appealing in the mobilization of CD34 + cells.…”

Efficacy of Plerixafor for Peripheral Stem Cell Mobilisation in Autologous Transplantation: A Single Centre Study

“…Average leucapheresis per person of 2.64 was achieved in PY group after adding plerixafor which was comparable to 2.47 in the PN group. A multi centre time motion analysis of plerixafor in poor mobilizers of non Hodgkins lymphoma patients showed that poor mobilizers who received plerixafor had a decrease in apheresis sessions and thereby costs [14]. Median value of apheresis CD34 count on day 1 was 1.75 in PY group and 2.63 in the PN group.…”