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- Title
Outcome, toxicity profile and cost analysis of autologous stem cell mobilization.
- Authors
Jagasia, M. H.; Savani, B. N.; Neff, A.; Dixon, S.; Chen, H.; Pickard, A. S.
- Abstract
Autologous stem cell mobilization (ASCM) is conventionally done using high-dose CY plus granulocyte colony-stimulating factor (G). It is important to examine the outcomes, toxicity profile and costs of ASCM associated with CY+G. A retrospective study was conducted in 236 patients with myeloma or lymphoma undergoing ASCM with CY+G. An ideal outcome was defined as 2 × 106 CD34+ cells/kg collected on the planned day of collection in 1 or 2 apheresis without a negative clinical event. The total cost of ASCM including clinical events, were reported based on Medicare part-B physician, laboratory and ancillary fee schedule. ASCM was successful in 213 (90%) patients, but an ideal outcome was seen in only 50 (20%) patients. Median (interquartile range, IQR) total cost of CY+G stem cells mobilization was $10 605 ($9230-$14 540). Ideal outcomes were associated with lower costs compared with non-ideal outcomes (median (IQR), $9914 ($8743-$11 168) versus $11232 ($9292-$15 518) respectively, P<0.001). The median (IQR) cost of non-ideal outcome was higher among lymphoma patients ($12 293 ($9578-$16 268)) compared with myeloma patients ($10 388 ($9355-$14 360) (P=0.04). Although mobilization success is eventually realized with CY+G, it has a low rate of ideal outcome, associated with significant adverse events and costs.
- Subjects
AUTOTRANSPLANTATION; STEM cell transplantation research; TOXICITY testing; GRANULOCYTE-colony stimulating factor; LYMPHOMAS; HEMAPHERESIS; COST analysis; PATIENTS
- Publication
Bone Marrow Transplantation, 2011, Vol 46, Issue 8, p1084
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2010.254