Retrospective comparison of filgrastim plus plerixafor to other regimens for remobilization after primary mobilization failure

Clinical and economic outcomes

Janelle B. Perkins, Jamie F. Shapiro, Ryan N. Bookout, Gary C Yee, Claudio Anasetti, William E. Janssen, Hugo F. Fernandez

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We performed a retrospective analysis to evaluate clinical and economic outcomes in patients receiving remobilization therapy after primary mobilization failure. Our primary endpoint was to compare filgrastim plus plerixafor to other regimens in their ability to collect a target cell dose of at least 2 million CD34+ cells/kg (cumulative). Of 96 consecutive patients who failed their primary mobilization therapy and in whom a second mobilization was attempted, remobilization consisted of filgrastim plus plerixafor (n = 38), filgrastim with or without sargramostim (n = 43), or chemotherapy plus filgrastim (n = 15), 84% of filgrastim/plerixafor patients were able to collect at least 2 million CD34+ cells/kg from both mobilizations, compared to 60% of patients mobilized with chemotherapy/filgrastim and 79% of the filgrastim ± sargramostim patients (P = 0.17). However, when combined with cells collected from the first mobilization, 53% of filgrastim/plerixafor patients reached the target of 2 million CD34+ cells in one apheresis, compared to 20% of those receiving chemotherapy/filgrastim and 28% of those receiving filgrastim ± sargramostim (P = 0.02). Resource utilization, mobilization drug costs, clinical care costs, and total costs were significantly different. We conclude that while filgrastim/plerixafor is the most efficient remobilization strategy, those clinical benefits may not translate into lower cost, especially when multiple days of plerixafor administration are required.

Original languageEnglish (US)
Pages (from-to)673-677
Number of pages5
JournalAmerican Journal of Hematology
Volume87
Issue number7
DOIs
StatePublished - Jul 1 2012

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Economics
Costs and Cost Analysis
Drug Therapy
JM 3100
Filgrastim
Blood Component Removal
Drug Costs
Therapeutics
sargramostim

ASJC Scopus subject areas

  • Hematology

Cite this

Retrospective comparison of filgrastim plus plerixafor to other regimens for remobilization after primary mobilization failure : Clinical and economic outcomes. / Perkins, Janelle B.; Shapiro, Jamie F.; Bookout, Ryan N.; Yee, Gary C; Anasetti, Claudio; Janssen, William E.; Fernandez, Hugo F.

In: American Journal of Hematology, Vol. 87, No. 7, 01.07.2012, p. 673-677.

Research output: Contribution to journalArticle

Perkins, Janelle B. ; Shapiro, Jamie F. ; Bookout, Ryan N. ; Yee, Gary C ; Anasetti, Claudio ; Janssen, William E. ; Fernandez, Hugo F. / Retrospective comparison of filgrastim plus plerixafor to other regimens for remobilization after primary mobilization failure : Clinical and economic outcomes. In: American Journal of Hematology. 2012 ; Vol. 87, No. 7. pp. 673-677.
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