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Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

GERTZ, M. A ; WOLF, R. C ; MICALLEF, Inm ; GASTINEAU, D. A

Bone marrow transplantation (Basingstoke), 2010-09, Vol.45 (9), p.1396-1403 [Periódico revisado por pares]

Basingstoke: Nature Publishing Group

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Título:
Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma
Autor: GERTZ, M. A ; WOLF, R. C ; MICALLEF, Inm ; GASTINEAU, D. A
Assuntos: Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Antibiotics ; Antineoplastic Agents - therapeutic use ; Apheresis ; Autografts ; Biological and medical sciences ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Cancer ; Care and treatment ; CD34 antigen ; Chemotherapy ; Combined Modality Therapy ; Databases, Factual ; Failure ; Female ; Growth factors ; Health aspects ; Hematopoietic Stem Cell Mobilization - statistics & numerical data ; Hodgkin Disease - drug therapy ; Hodgkin Disease - mortality ; Hodgkin Disease - therapy ; Hodgkin's lymphoma ; Humans ; Immunodeficiencies. Immunoglobulinopathies ; Immunoglobulinopathies ; Immunopathology ; Lymphoma ; Lymphoma, Non-Hodgkin - drug therapy ; Lymphoma, Non-Hodgkin - mortality ; Lymphoma, Non-Hodgkin - therapy ; Lymphomas ; Male ; Malignancy ; Medical sciences ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - drug therapy ; Multiple Myeloma - mortality ; Multiple Myeloma - therapy ; Patient outcomes ; Patients ; Resource Allocation - utilization ; Resource consumption ; Resource utilization ; Retrospective Studies ; Stem cell transplantation ; Stem cells ; Survival Rate ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Treatment Failure
É parte de: Bone marrow transplantation (Basingstoke), 2010-09, Vol.45 (9), p.1396-1403
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Descrição: High-dose chemotherapy in conjunction with auto-SCT is the preferred treatment of relapsed Hodgkin disease and non-Hodgkin lymphoma and newly diagnosed multiple myeloma. Failure to achieve optimal stem cell mobilization results in multiple subsequent attempts, which consumes large amounts of growth factors and potentially requires antibiotics and transfusions. We retrospectively reviewed the natural history of stem cell mobilization attempts at our institution from 2001 to 2007 to determine the frequency of suboptimal mobilization in patients with hematologic malignancy undergoing autologous transplant and analyzed the subsequent resource utilization in patients with initially failed attempts. Of 1775 patients undergoing mobilization during the study period, stem cell collection (defined by the number of CD34+ cells/kg) was 'optimal' (> or = 5 x 10(6)) in 53%, 'low' (> or = 2-5 x 10(6)) in 25%, 'poor' (<2 x 10(6)) in 10%, and 'failed' (<10 CD34+ cells/microl) in 12%. In the 47% of collections that were less than optimal, increased resource consumption included increased use of growth factors and antibiotics, subsequent chemotherapy mobilization, increased transfusional support, more apheresis procedures, and more frequent hospitalization. This usually unappreciated resource utilization associated with stem cell mobilization failure highlights the need for more effective mobilization strategies.
Editor: Basingstoke: Nature Publishing Group
Idioma: Inglês

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Clinical impact and resource utilization after stem cell mobilization failure in patients with multiple myeloma and lymphoma

GERTZ, M. A ; WOLF, R. C ; MICALLEF, Inm ; GASTINEAU, D. A

Basingstoke: Nature Publishing Group

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