Application of First-Line Steady-State Mobilization vs. Conventional Chemotherapy Mobilization for Peripheral Hematopoietic Stem Cell Mobilization in Newly Diagnosed Multiple Myeloma Patients

Han X, Xiong Y, Huang X, Zheng G, Chen J, Guan F, He J, Zhao Y, Wu W, He D, Yang Y, Chen Q, Yang Q, Shi J, Luo Y, Huang H and Cai Z

Bone Marrow Transplantation Center, Zhejiang University School of Medicine, First Affiliated Hospital, China
Department of Hematology and Oncology, Taizhou First People's Hospital, China
These authors contributed equally to this work

^*Correspondance to: Zhen Cai 

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Abstract:

Background: Plerixafor plus G-CSF (PLE+G-CSF) has demonstrated superior mobilization efficacy when compared with Cyclophosphamide plus G-CSF (CY+G-CSF) in Multiple Myeloma (MM) patients. However, the cost of plerixafor is relatively high in China. We aimed to explore a more efficient and economical mobilization scheme of HSC mobilization.
Methods: Outcomes of 95 patients with MM mobilized using P+G-CSF (n=47) or CY+G-CSF (n=48) before ASCT in our center were retrospectively analyzed. Only one preparation of plerixafor (sufficient dose in the first injection and the remaining in the second injection) was used in our center for steady-state mobilization. The mobilization efficiency, adverse reactions, average total
cost of mobilization, and hematopoietic reconstruction after transplantation were analyzed and compared.
Results: The plerixafor mobilization strategy increased the success rate of mobilization (87.2% vs. 70.8%, P=0.050) and reduced the times of apheresis ((1 (1, 2) d vs. 2 (1, 3) d, P<0.001) compared with the CY+G-CSF group. There was no significant difference in the time of hematopoietic reconstruction between the two groups. PLE+G-CSF was associated with higher financial burden as high cost of plerixafor ($12,227.6 vs. $3,545.7, P<0.001), but lower rate of hospitalization, reduced need for salvage mobilization and antibiotics uses. Conclusion: Our findings showed that even with one vial of plerixafor used for the whole mobilization process, PLE+G-CSF strategy, partially relieving the economic burden, had a higher success rate, fewer apheresis times, and lower adverse reactions than the CY+CSF strategy.

Keywords:

Multiple myeloma; Hematopoietic stem cell mobilization; Autologous hematopoietic cell transplantation; Cyclophosphamide; Granulocyte colony-stimulating factor

Cite the Article:

Han X, Xiong Y, Huang X, Zheng G, Chen J, Guan F, et al. Application of First-Line Steady-State Mobilization vs. Conventional Chemotherapy Mobilization for Peripheral Hematopoietic Stem Cell Mobilization in Newly Diagnosed Multiple Myeloma Patients. Clin Oncol. 2022;7:1977..