Azar Nabih, Ouzegdouh Maya, Choquet Sylvain, Leblond Véronique
Hematology department, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, Paris, 75013, France.
J Clin Apher. 2018 Feb;33(1):5-13. doi: 10.1002/jca.21551. Epub 2017 Apr 28.
Plerixafor (Mozobil) in combination with granulocyte colony-stimulating factor (G-CSF) has shown to increase mobilization of peripheral blood stem cells (PBSC) as compared to G-CSF alone in patients undergoing autologous stem cell transplantation (ASCT). However, up to 25% of patients treated with G-CSF alone still fail mobilization. Adding plerixafor to poor mobilizers allows to rescue these patients from mobilization failure and to reduce the number of apheresis sessions. The goal of this retrospective study was to capture the impact of plerixafor on treatment outcome and on apheresis department efficiency. The latter was measured in terms of time-slots lost, that is, the number of apheresis sessions scheduled but not carried out due to poor mobilization, and the number of elective apheresis sessions performed for patients undergoing extracorporeal photopheresis (ECP). Hospital records of patients treated before and after introduction of plerixafor were collected and analyzed. With plerixafor, the mobilization failure rate dropped from 12% to 4% and the mean number of time-slots lost per patient dropped from 1.39 to 0.89. Additional drug costs due to plerixafor were partially balanced by a reduction in apheresis sessions, resulting in an additional cost of 759€ per ASCT candidate. More importantly, with the use of plerixafor, the availability of time-slots turned from erratic to predictable such that freed capacity could be dedicated to other apheresis procedures. As a result, the number of ECP sessions increased from 0 in 2005 to 685 sessions in 2014.
与单独使用粒细胞集落刺激因子（G-CSF）相比，普乐沙福（Mozobil）联合G-CSF已显示可增加接受自体干细胞移植（ASCT）患者外周血干细胞（PBSC）的动员。然而，单独接受G-CSF治疗的患者中仍有高达25%的人动员失败。对于动员效果不佳的患者添加普乐沙福可使这些患者避免动员失败，并减少单采次数。这项回顾性研究的目的是了解普乐沙福对治疗结果和单采部门效率的影响。后者通过丢失的时间段来衡量，即因动员不佳而安排但未进行的单采次数，以及为接受体外光化学疗法（ECP）的患者进行的择期单采次数。收集并分析了在引入普乐沙福前后接受治疗患者的医院记录。使用普乐沙福后，动员失败率从12%降至4%，每位患者平均丢失的时间段从1.39降至0.89。普乐沙福带来的额外药物成本因单采次数减少而得到部分抵消，每位ASCT候选患者的额外成本为759欧元。更重要的是，使用普乐沙福后，时间段的可用性从不稳定变为可预测，从而使腾出的容量可用于其他单采程序。结果，ECP的次数从2005年的0次增加到2014年的685次。
