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Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone.

Publication ,  Journal Article
Sung, AD; Grima, DT; Bernard, LM; Brown, S; Carrum, G; Holmberg, L; Horwitz, ME; Liesveld, JL; Kanda, J; McClune, B; Shaughnessy, P; Chao, NJ ...
Published in: Bone Marrow Transplant
November 2013

Chemotherapy plus G-CSF (C+G) and G-CSF alone are two of the most common methods used to mobilize CD34(+) cells for autologous hematopoietic SCT (AHSCT). In order to compare and determine the real-world outcomes and costs of these strategies, we performed a retrospective study of 226 consecutive patients at 11 medical centers (64 lymphoma, 162 multiple myeloma), of whom 55% of lymphoma patients and 66% of myeloma patients received C+G. Patients with C+G yielded more CD34(+) cells/day than those with G-CSF alone (lymphoma: average 5.51 × 10(6) cells/kg on day 1 vs 2.92 × 10(6) cells/kg, P=0.0231; myeloma: 4.16 × 10(6) vs 3.69 × 10(6) cells/kg, P<0.00001) and required fewer days of apheresis (lymphoma: average 2.11 vs 2.96 days, P=0.012; myeloma: 2.02 vs 2.83 days, P=0.0015), although nearly all patients ultimately reached the goal of 2 × 10(6) cells/kg. With the exception of higher rates of febrile neutropenia in myeloma patients with C+G (17% vs 2%, P<0.05), toxicities and other outcomes were similar. Mobilization with C+G cost significantly more (lymphoma: median $10,300 vs $7300, P<0.0001; myeloma: $8800 vs $5600, P<0.0001), although re-mobilization adds $6700 for drugs alone. Our results suggest that although both C+G and G-CSF alone are effective mobilization strategies, C+G may be more cost-effective for patients at high risk of insufficient mobilization.

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Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

November 2013

Volume

48

Issue

11

Start / End Page

1444 / 1449

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation, Autologous
  • Rituximab
  • Retrospective Studies
  • Middle Aged
  • Male
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
 

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APA
Chicago
ICMJE
MLA
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Sung, A. D., Grima, D. T., Bernard, L. M., Brown, S., Carrum, G., Holmberg, L., … Chao, N. J. (2013). Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone. Bone Marrow Transplant, 48(11), 1444–1449. https://doi.org/10.1038/bmt.2013.80
Sung, A. D., D. T. Grima, L. M. Bernard, S. Brown, G. Carrum, L. Holmberg, M. E. Horwitz, et al. “Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone.Bone Marrow Transplant 48, no. 11 (November 2013): 1444–49. https://doi.org/10.1038/bmt.2013.80.
Sung AD, Grima DT, Bernard LM, Brown S, Carrum G, Holmberg L, et al. Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone. Bone Marrow Transplant. 2013 Nov;48(11):1444–9.
Sung, A. D., et al. “Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone.Bone Marrow Transplant, vol. 48, no. 11, Nov. 2013, pp. 1444–49. Pubmed, doi:10.1038/bmt.2013.80.
Sung AD, Grima DT, Bernard LM, Brown S, Carrum G, Holmberg L, Horwitz ME, Liesveld JL, Kanda J, McClune B, Shaughnessy P, Tricot GJ, Chao NJ. Outcomes and costs of autologous stem cell mobilization with chemotherapy plus G-CSF vs G-CSF alone. Bone Marrow Transplant. 2013 Nov;48(11):1444–1449.

Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

November 2013

Volume

48

Issue

11

Start / End Page

1444 / 1449

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation, Autologous
  • Rituximab
  • Retrospective Studies
  • Middle Aged
  • Male
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation