3PC-024 Effectiveness of plerixafor in haematopoietic stem cell mobilisation and repackaging strategy to reduce cost
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Plerixafor is indicated in combination with granulocyte-colony stimulating factor (G-CSF) to enhance mobilisation of haematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in adult patients with lymphoma or multiple myeloma whose cells mobilise poorly. Aim and Objectives Assessing the use of plerixafor in routine clinical practice and to evaluate its effectiveness, and perform an economic analysis of the cost avoided by repackaging vials. Material and Methods Observational, retrospective, descriptive study that included all patients who received plerixafor between January 2018-July 2024. Data were collected using the electronic medical record. Variables analysed: age, sex, diagnosis, type of previous mobilisation therapies, CD34+ cell concentration in peripheral blood (PB) and plerixafor dose administered. Apheresis requires a minimum CD34+ cells count in PB >10 cells/µL. Standard successful mobilisation was considered to be the collection of ≥2x106 CD34+cells/kg and optimal in the case of ≥5x106 CD34+cells/kg. An analysis of the avoided cost associated with the repackaging of vials is also performed. Results Forty-two patients were included. The median age was 58.65±10.71 years old and 52.38% (n=22) were men. The diagnoses were 21 (50%) multiple myeloma, eight (18.04%) non-Hodgkin’s lymphoma, seven (16.66%) donors, four (9.52%) Hodgkin’s lymphoma, one (2.38%) lymphomatoid-granulomatosis; therefore, in 81.96% (34/42) of the cases, its use has been adjusted to the Summary of Product Characteristics. Previous therapies: 18 patients failed to mobilise with G-CSF, 12 with etoposide-G-CSF, seven cyclophosphamide-G-CSF, four etoposide-G-CSF and cyclophosphamide-G-CSF, one etoposide-G-CSF and gemcitabine. 36 patients (85.71%) reached an adequate level of CD34+ cells in PB to perform apheresis. The dose of plerixafor used was 0.24 mg/kg/day with an average dose of 18.6-mg. Plerixafor has been prepared in a horizontal laminar flow hood, keeping the unused drug fraction in a refrigerator, stability of 84 days. The average wholesale price of a 24-mg vial of plerixafor is €4,846.36. If it had not been repackaged, the total cost would have been €203,547.12, but it was €150,242.37, representing a saving cost of €53,304.75. Conclusion and Relevance Plerixafor has been shown to be effective for the mobilisation of haematopoietic progenitors in patients refractory to standard regimens. The development of a repackaging strategy has been shown to be efficient since more patients can be treated with the same budget. References and/or Acknowledgements Conflict of Interest No conflict of interest
Institution: Hospital Regional Universitario de Málaga
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376034