Plerixafor use in New Zealand 2016-2019: an observational study

Area of Science:

• Hematology
• Oncology
• Stem Cell Transplantation

Background:

• Plerixafor mobilizes CD34-positive stem cells for autologous transplantation in hematological malignancies.
• Plerixafor is funded in New Zealand for preemptive or rescue stem cell mobilization strategies.
• Data on plerixafor uptake and success rates in New Zealand were previously unknown.

Approach:

• A retrospective review of 203 consecutive myeloma and lymphoma patients undergoing stem cell mobilization at Christchurch hospital from 2016 to 2019.
• Data collected included demographics, conditioning regimens, harvest outcomes, and apheresis duration.
• Successful harvest was defined as collecting >2 × 10^6 CD34+ cells/kg.

Key Points:

• Seventeen percent of patients received plerixafor.
• Harvest success rates were 77% (lymphoma) and 86% (myeloma) with standard conditioning.
• Preemptive plerixafor achieved 95% (lymphoma) and 100% (myeloma) success, while rescue plerixafor achieved 71% (lymphoma) and 89% (myeloma).
• 'Pre-emptive' plerixafor was non-inferior to standard conditioning.
• Local guidelines resulted in successful harvests for 96% of lymphoma and 99% of myeloma patients.

Conclusions:

• Plerixafor strategies in New Zealand achieve successful stem cell mobilization in over 96% of patients.
• Further research is needed to assess the cost-effectiveness of increased plerixafor use.
• Potential benefits include reduced chemotherapy, shorter apheresis duration, and improved graft quality.