A1 Refereed original research article in a scientific journal
Cost analysis of a randomized stem cell mobilization study in multiple myeloma
Authors: Varmavuo V, Silvennoinen R, Anttila P, Saily M, Sankelo M, Putkonen M, Ahonen J, Mahlamaki E, Mantymaa P, Savolainen ER, Remes K, Jantunen E
Publisher: SPRINGER
Publication year: 2016
Journal: Annals of Hematology
Volume: 95
Issue: 10
First page : 1653
Last page: 1659
Number of pages: 7
ISSN: 0939-5555
eISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-016-2772-1
Upfront autologous stem cell transplantation (ASCT) is the standard therapy for younger multiple myeloma (MM) patients. MM patients usually undergo stem cell mobilization with cyclophosphamide (CY) followed by granulocyte colony-stimulating factor (G-CSF), or with G-CSF alone. A limited number of randomized studies are available comparing costs of different mobilization strategies. Eighty transplant-eligible patients aged up to 70 years with untreated MM were included in this prospective study. The patients were treated with RVD induction for three 21-day cycles and randomized 1: 1 at inclusion into one of the two mobilization arms CY 2 g/m(2) + G-CSF [arm A] vs. G-CSF alone [arm B]. Plerixafor was given according to a specific algorithm if needed. Sixty-nine patients who received mobilization followed by blood graft collection were included in the cost analysis. The median total costs of the mobilization phase were significantly higher in arm A than in arm B (3855 (sic) vs. 772 (sic), p <= 0.001). The cumulative median cost of the mobilization and collection phases was significantly lower in arm B than in arm A (8524 (sic) vs. 11,622 (sic), p = 0.012). There was no significant difference between the arms in the total median costs of ASCT (n = 59) (34,997 (sic) in arm Avs. 31,981 (sic) in arm B, p = 0.118). Mobilization with G-CSF alone seems to be a preferable mobilization method for MM patients in terms of mobilization and apheresis costs. In addition, it requires less hospital resource utilization.