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| Main Authors: | , , , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2025
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| Subjects: | |
| Online Access: | https://onlinelibrary.wiley.com/doi/10.1002/jca.70026 |
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Table of Contents:
- Cost‐Effectiveness of Preemptive Plerixafor Versus Rescue Plerixafor for Mobilization and Collection of Hematopoietic Stem Cells in Patients With Multiple Myeloma and Lymphoma Roselene Mesquita Augusto Passos Miriam Allein Zago Marcolino Júlia Augusto Passos Vinicius Fernando Calsavara Leila de Lourdes Martins Perobelli Alessandro Gonçalves Campolina Cesar de Almeida‐Neto Journal of Clinical Apheresis ABSTRACTBackgroundPlerixafor combined with granulocyte colony‐stimulating factor (G‐CSF) has shown superior efficacy in mobilizing hematopoietic stem cells (HSCs). However, its widespread use is constrained by high costs, and there is ongoing debate regarding the effectiveness of mobilization strategies. This study evaluated the cost‐effectiveness of preemptive versus rescue plerixafor in patients from the Brazilian Public Health Care System with multiple myeloma or lymphoma eligible for autologous stem cell transplantation (ASCT).MethodsThis observational study assessed the costs and clinical outcomes of preemptive and rescue plerixafor strategies. The incremental cost‐effectiveness ratio (ICER) was calculated for the percentage of patients with successful optimal or minimal HSC collections, who underwent ASCT and the number of leukapheresis sessions.ResultsThe study included 285 patients, 82 in the preemptive and 203 in the rescue group. Preemptive plerixafor resulted in a lower mobilization failure rate, a decreased need for remobilization, a higher proportion of patients progressing to ASCT, and a shorter interval between the beginning of mobilization and ASCT. The incremental cost of preemptive versus rescue plerixafor was US$ 1532.44. The incremental effectiveness observed was 10.1% for minimally successful harvest (ICER US$ 151.28), 4.7% for optimal harvest (ICER US$ 326.05), and 13.1% for patients progressing to ASCT (ICER US$ 116.18). Regarding the number of leukapheresis sessions, preemptive plerixafor was dominated.SummaryPreemptive plerixafor is a cost‐effective strategy compared to rescue plerixafor, offering higher efficacy and lower ICER values, making it a clinically beneficial option despite its higher cost. 10.1002/jca.70026 http://creativecommons.org/licenses/by/4.0/