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Cost analysis of a randomized stem cell mobilization study in multiple myeloma




TekijätVarmavuo V, Silvennoinen R, Anttila P, Saily M, Sankelo M, Putkonen M, Ahonen J, Mahlamaki E, Mantymaa P, Savolainen ER, Remes K, Jantunen E

KustantajaSPRINGER

Julkaisuvuosi2016

JournalAnnals of Hematology

Vuosikerta95

Numero10

Aloitussivu1653

Lopetussivu1659

Sivujen määrä7

ISSN0939-5555

eISSN1432-0584

DOIhttps://doi.org/10.1007/s00277-016-2772-1


Tiivistelmä

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.



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