Abstract
A successful stem cell harvest is a prerequisite for peripheral blood SCT. We investigated the number of CD34(+) cells mobilized, the number of leukaphereses needed and the expenses of treatment for 28 patients with multiple myeloma randomly assigned to receive either G-CSF alone or G-CSF + EPO for stem cell mobilization after chemotherapy with ifosfamide, epirubicin and etoposide. All patients ...
Abstract
A successful stem cell harvest is a prerequisite for peripheral blood SCT. We investigated the number of CD34(+) cells mobilized, the number of leukaphereses needed and the expenses of treatment for 28 patients with multiple myeloma randomly assigned to receive either G-CSF alone or G-CSF + EPO for stem cell mobilization after chemotherapy with ifosfamide, epirubicin and etoposide. All patients treated with G-CSF + EPO reached the threshold of 6 x 10(6) CD34(+) cells per kg body weight (kgbw), with a mean of 1.3 leukaphereses. On average 15.4 x 10(6) CD34(+) cells/kgbw were collected. In the G-CSF-alone group, the mean number of leukaphereses was 1.8, and 12.6 x 10(6) CD34(+) cells/kgbw were collected, and two patients failed the threshold. Overall costs per patient for mobilization and leukaphereses were (sic)8339 (G-CSF + EPO) and (sic)8842 (G-CSF). After transplantation, fewer blood transfusions (0.6 versus 1.3, P = 0.05), fewer days on antibiotics (2.3 versus 6.1, P = 0.02) and a shorter hospital stay (15.2 versus 17.8, P = 0.06) were noted in the G-CSF + EPO group resulting in a 19.2% reduction of costs for each transplant (P = 0.018). In summary, EPO improves the mobilization efficiency of G-CSF and so reduces costs of mobilization and SCT.
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