Effectiveness of etoposide chemomobilization in lymphoma patients undergoing auto-SCT.

Published

Journal Article

The effectiveness of stem cell mobilization with G-CSF in lymphoma patients is suboptimal. We reviewed our institutional experience using chemomobilization with etoposide (VP-16; 375 mg/m(2) on days +1 and +2) and G-CSF (5 μg/kg twice daily from day +3 through the final day of collection) in 159 patients with lymphoma. This approach resulted in successful mobilization (>2 × 10(6) CD34+ cells collected) in 94% of patients (83% within 4 apheresis sessions). Fifty-seven percent of patients yielded at least 5 × 10(6) cells in 2 days and were defined as good mobilizers. The regimen was safe with a low rate of rehospitalization. Average costs were $14 923 for good mobilizers and $27 044 for poor mobilizers (P<0.05). Using our data, we performed a 'break-even' analysis that demonstrated that adding two doses of Plerixafor to predicted poor mobilizers at the time of first CD34+ cell count would achieve cost neutrality if the frequency of good mobilizers were to increase by 21%, while the frequency of good mobilizers would need to increase by 25% if three doses of Plerixafor were used. We conclude that chemomobilization with etoposide and G-CSF in patients with lymphoma is effective, with future opportunities for cost-neutral improvement using novel agents.

Full Text

Duke Authors

Cited Authors

  • Wood, WA; Whitley, J; Goyal, R; Brown, PM; Sharf, A; Irons, R; Rao, KV; Essenmacher, A; Serody, JS; Coghill, JM; Armistead, PM; Sarantopoulos, S; Gabriel, DA; Shea, TC

Published Date

  • June 2013

Published In

Volume / Issue

  • 48 / 6

Start / End Page

  • 771 - 776

PubMed ID

  • 23165501

Pubmed Central ID

  • 23165501

Electronic International Standard Serial Number (EISSN)

  • 1476-5365

Digital Object Identifier (DOI)

  • 10.1038/bmt.2012.216

Language

  • eng

Conference Location

  • England