title: A plerixafor-based strategy allows adequate hematopoietic stem cell collection in poor mobilizers: results from the Canadian Special Access Program.
abstract: Plerixafor effectively mobilizes hematopoietic stem cells (HSCs). However, most patients' cells are successfully collected using traditional strategies and there is limited cost-effectiveness data. The objectives of this study were to: (1) summarize the published reports of mobilization using a plerixafor-based strategy during compassionate access programs and (2) describe the Canadian experience with plerixafor during its availability by Health Canada's Special Access Program. A literature search identified reports of plerixafor-based mobilization during compassionate access programs. Overall, successful collection of at least 2 × 10(6) CD34+ cells/kg was achieved in ~75% of patients, and about two-thirds of patients went on to HSCT. A greater proportion of patients had successful collections when plerixafor was used in the upfront or preemptive settings. Plerixafor was made available by Health Canada's SAP from September 2008 to December 2010. In 96 of 132 (73%) patients, there was successful collection of at least 2 × 10(6) CD34+ cells/kg. Ninety-nine (75%) patients went on to receive an autologous transplant. Plerixafor-based mobilization is effective in perceived poor mobilizers. The optimal way to incorporate plerixafor into a mobilization strategy, however, remains to be determined. Centre-specific analysis of resource utilization may help to identify the most cost-effective way to implement various plerixafor-based mobilization strategies.
authors.affiliation: Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Sheppard
authors.affiliation: Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Bredeson
authors.affiliation: Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Huebsch
authors.affiliation: Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Allan
authors.affiliation: Blood and Marrow Transplant Program, Division of Hematology, Department of Medicine, The Ottawa Hospital, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Tay
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols; D064592:Autografts; D001596:Benzylamines; D002170:Canada; D057176:Compassionate Use Trials; D003362:Cost-Benefit Analysis; D000080027:Cyclams; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization / Q000191:economics / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000276:immunology; D006571:Heterocyclic Compounds / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D001596:Benzylamines; D000080027:Cyclams; D006571:Heterocyclic Compounds; C088327:plerixafor