Clinical and cost outcomes of pre-emptive plerixafor administration in patients with multiple myeloma undergoing stem cell mobilization

Leslie A. Andritsos, Ying Huang, Ivo L Abraham, Keith Huff, Scott R. Scrape, Tao Fan, Nimer Alkhatib, Craig C. Hofmeister, Edward Drea, Ali McBride

Research output: Contribution to journalArticle

Abstract

Purpose: The stem cell mobilization agent plerixafor significantly improves CD34+ stem cell procurement in patients with multiple myeloma undergoing autologous stem cell transplant. We compared mobilization success rates and costs of two regimens of plerixafor administration: pre-emptive (P-PL, initiated the evening prior to the first day of stem cell collection) and standard (S-PL, initiated the evening prior to the second day of stem cell collection in the event of inadequate collection on the first day). Methods: Patients with multiple myeloma undergoing mobilization were categorized as either P-PL or S-PL. Stem cell collection success was evaluated using logistic regression models. Associated costs were aggregated in terms of average collections per patient in each mobilization option (patient level), and escalated to a panel of 5000 patients (population level). Results: 299 patients were evaluable; 241 received P-PL and 58 received S-PL. Patients receiving P-PL had higher median CD34+ count pre-collection and higher median total CD34+ cell harvest on the first collection (6.75 × 106/kg for P-PL, 1.96 × 106/kg for S-PL; P<0.01). In multivariable analyses, P-PL remained significantly associated with the ability to collect ≥2 × 106/kg CD34+ on the first day (OR = 4.05, 95% CI, 1.19–13.83, P = 0.03) and ≥5x106/kg CD34+ in total (OR = 3.09, 95% CI, 1.04–9.23, P = 0.04). P-PL saved $11,248 (46%) per patient compared with S-PL. Conclusion: P-PL significantly enhanced collection efficiency, with most patients completing collection in 1 day, resulting in substantial cost savings.

Original languageEnglish (US)
Article number106215
JournalLeukemia Research
Volume85
DOIs
StatePublished - Oct 1 2019

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Hematopoietic Stem Cell Mobilization
Multiple Myeloma
Costs and Cost Analysis
Stem Cells
Logistic Models
JM 3100
Cost Savings
Transplants

Keywords

  • Cost analysis
  • Multiple myeloma
  • Outcomes
  • Plerixafor
  • Stem cell mobilization

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Clinical and cost outcomes of pre-emptive plerixafor administration in patients with multiple myeloma undergoing stem cell mobilization. / Andritsos, Leslie A.; Huang, Ying; Abraham, Ivo L; Huff, Keith; Scrape, Scott R.; Fan, Tao; Alkhatib, Nimer; Hofmeister, Craig C.; Drea, Edward; McBride, Ali.

In: Leukemia Research, Vol. 85, 106215, 01.10.2019.

Research output: Contribution to journalArticle

Andritsos, Leslie A. ; Huang, Ying ; Abraham, Ivo L ; Huff, Keith ; Scrape, Scott R. ; Fan, Tao ; Alkhatib, Nimer ; Hofmeister, Craig C. ; Drea, Edward ; McBride, Ali. / Clinical and cost outcomes of pre-emptive plerixafor administration in patients with multiple myeloma undergoing stem cell mobilization. In: Leukemia Research. 2019 ; Vol. 85.
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abstract = "Purpose: The stem cell mobilization agent plerixafor significantly improves CD34+ stem cell procurement in patients with multiple myeloma undergoing autologous stem cell transplant. We compared mobilization success rates and costs of two regimens of plerixafor administration: pre-emptive (P-PL, initiated the evening prior to the first day of stem cell collection) and standard (S-PL, initiated the evening prior to the second day of stem cell collection in the event of inadequate collection on the first day). Methods: Patients with multiple myeloma undergoing mobilization were categorized as either P-PL or S-PL. Stem cell collection success was evaluated using logistic regression models. Associated costs were aggregated in terms of average collections per patient in each mobilization option (patient level), and escalated to a panel of 5000 patients (population level). Results: 299 patients were evaluable; 241 received P-PL and 58 received S-PL. Patients receiving P-PL had higher median CD34+ count pre-collection and higher median total CD34+ cell harvest on the first collection (6.75 × 106/kg for P-PL, 1.96 × 106/kg for S-PL; P<0.01). In multivariable analyses, P-PL remained significantly associated with the ability to collect ≥2 × 106/kg CD34+ on the first day (OR = 4.05, 95{\%} CI, 1.19–13.83, P = 0.03) and ≥5x106/kg CD34+ in total (OR = 3.09, 95{\%} CI, 1.04–9.23, P = 0.04). P-PL saved $11,248 (46{\%}) per patient compared with S-PL. Conclusion: P-PL significantly enhanced collection efficiency, with most patients completing collection in 1 day, resulting in substantial cost savings.",
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T1 - Clinical and cost outcomes of pre-emptive plerixafor administration in patients with multiple myeloma undergoing stem cell mobilization

AU - Andritsos, Leslie A.

AU - Huang, Ying

AU - Abraham, Ivo L

AU - Huff, Keith

AU - Scrape, Scott R.

AU - Fan, Tao

AU - Alkhatib, Nimer

AU - Hofmeister, Craig C.

AU - Drea, Edward

AU - McBride, Ali

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N2 - Purpose: The stem cell mobilization agent plerixafor significantly improves CD34+ stem cell procurement in patients with multiple myeloma undergoing autologous stem cell transplant. We compared mobilization success rates and costs of two regimens of plerixafor administration: pre-emptive (P-PL, initiated the evening prior to the first day of stem cell collection) and standard (S-PL, initiated the evening prior to the second day of stem cell collection in the event of inadequate collection on the first day). Methods: Patients with multiple myeloma undergoing mobilization were categorized as either P-PL or S-PL. Stem cell collection success was evaluated using logistic regression models. Associated costs were aggregated in terms of average collections per patient in each mobilization option (patient level), and escalated to a panel of 5000 patients (population level). Results: 299 patients were evaluable; 241 received P-PL and 58 received S-PL. Patients receiving P-PL had higher median CD34+ count pre-collection and higher median total CD34+ cell harvest on the first collection (6.75 × 106/kg for P-PL, 1.96 × 106/kg for S-PL; P<0.01). In multivariable analyses, P-PL remained significantly associated with the ability to collect ≥2 × 106/kg CD34+ on the first day (OR = 4.05, 95% CI, 1.19–13.83, P = 0.03) and ≥5x106/kg CD34+ in total (OR = 3.09, 95% CI, 1.04–9.23, P = 0.04). P-PL saved $11,248 (46%) per patient compared with S-PL. Conclusion: P-PL significantly enhanced collection efficiency, with most patients completing collection in 1 day, resulting in substantial cost savings.

AB - Purpose: The stem cell mobilization agent plerixafor significantly improves CD34+ stem cell procurement in patients with multiple myeloma undergoing autologous stem cell transplant. We compared mobilization success rates and costs of two regimens of plerixafor administration: pre-emptive (P-PL, initiated the evening prior to the first day of stem cell collection) and standard (S-PL, initiated the evening prior to the second day of stem cell collection in the event of inadequate collection on the first day). Methods: Patients with multiple myeloma undergoing mobilization were categorized as either P-PL or S-PL. Stem cell collection success was evaluated using logistic regression models. Associated costs were aggregated in terms of average collections per patient in each mobilization option (patient level), and escalated to a panel of 5000 patients (population level). Results: 299 patients were evaluable; 241 received P-PL and 58 received S-PL. Patients receiving P-PL had higher median CD34+ count pre-collection and higher median total CD34+ cell harvest on the first collection (6.75 × 106/kg for P-PL, 1.96 × 106/kg for S-PL; P<0.01). In multivariable analyses, P-PL remained significantly associated with the ability to collect ≥2 × 106/kg CD34+ on the first day (OR = 4.05, 95% CI, 1.19–13.83, P = 0.03) and ≥5x106/kg CD34+ in total (OR = 3.09, 95% CI, 1.04–9.23, P = 0.04). P-PL saved $11,248 (46%) per patient compared with S-PL. Conclusion: P-PL significantly enhanced collection efficiency, with most patients completing collection in 1 day, resulting in substantial cost savings.

KW - Cost analysis

KW - Multiple myeloma

KW - Outcomes

KW - Plerixafor

KW - Stem cell mobilization

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