3PC-024 Effectiveness of plerixafor in haematopoietic stem cell mobilisation and repackaging strategy to reduce cost

<h3>Background and Importance</h3> Plerixafor is indicated in combination with granulocyte-colony stimulating factor (G-CSF) to enhance mobilisation of haematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in adult patients with lymphoma or multiple myeloma whose cells mobilise poorly. <h3>Aim and Objectives</h3> Assessing the use of plerixafor in routine clinical practice and to evaluate its effectiveness, and perform an economic analysis of the cost avoided by repackaging vials. <h3>Material and Methods</h3> Observational, retrospective, descriptive study that included all patients who received plerixafor between January 2018-July 2024. Data were collected using the electronic medical record. Variables analysed: age, sex, diagnosis, type of previous mobilisation therapies, CD34+ cell concentration in peripheral blood (PB) and plerixafor dose administered. Apheresis requires a minimum CD34+ cells count in PB &gt;10 cells/µL. Standard successful mobilisation was considered to be the collection of ≥2x10⁶ CD34+cells/kg and optimal in the case of ≥5x10⁶ CD34+cells/kg. An analysis of the avoided cost associated with the repackaging of vials is also performed. <h3>Results</h3> Forty-two patients were included. The median age was 58.65±10.71 years old and 52.38% (n=22) were men. The diagnoses were 21 (50%) multiple myeloma, eight (18.04%) non-Hodgkin’s lymphoma, seven (16.66%) donors, four (9.52%) Hodgkin’s lymphoma, one (2.38%) lymphomatoid-granulomatosis; therefore, in 81.96% (34/42) of the cases, its use has been adjusted to the Summary of Product Characteristics. Previous therapies: 18 patients failed to mobilise with G-CSF, 12 with etoposide-G-CSF, seven cyclophosphamide-G-CSF, four etoposide-G-CSF and cyclophosphamide-G-CSF, one etoposide-G-CSF and gemcitabine. 36 patients (85.71%) reached an adequate level of CD34+ cells in PB to perform apheresis. The dose of plerixafor used was 0.24 mg/kg/day with an average dose of 18.6-mg. Plerixafor has been prepared in a horizontal laminar flow hood, keeping the unused drug fraction in a refrigerator, stability of 84 days. The average wholesale price of a 24-mg vial of plerixafor is €4,846.36. If it had not been repackaged, the total cost would have been €203,547.12, but it was €150,242.37, representing a saving cost of €53,304.75. <h3>Conclusion and Relevance</h3> Plerixafor has been shown to be effective for the mobilisation of haematopoietic progenitors in patients refractory to standard regimens. The development of a repackaging strategy has been shown to be efficient since more patients can be treated with the same budget. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest