MOTIXAFORTIDE INJ,LYPHL
Clinical Criteria Summary
Document 648
Indication & Patient Population
- Indicated for use in combination with filgrastim to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with multiple myeloma.
Dosing & Administration
- Dose: 1.25 mg/kg (actual wgt).
- Route: Slow subcutaneous injection.
- Timing: Administered 10–14 hours prior to initiation of the first apheresis.
- A second dose may be administered 10–14 hours prior to a third apheresis if needed.
Contraindications & Safety Monitoring
- Contraindicated in patients with a history of hypersensitivity to motixafortide.
- Premedicate with H1-, H2-blocker and leukotriene inhibitor; administer in a staffed and equipped setting where immediate treatment can be provided for anaphylactic shock and hypersensitivity reactions.
- Premedication with acetaminophen is recommended to manage injection site reactions.
- Monitor WBC counts due to potential for leukocytosis.
- Advise patients of embryo-fetal toxicity risk; require use of effective contraception.
VHA-Specific Use Cases
- Consider for patients with hypersensitivity or allergy to plerixafor.
- Consider for patients experiencing insufficient cell mobilization utilizing filgrastim and plerixafor.
- Should be available in HSCT settings in anticipation of inadequate PBSC collections.
Document 633
Exclusion Criteria
- Leukemia diagnosis
- Pregnancy
- Lactating
Inclusion Criteria
- Care provided by a VA/VA Community Care hematology or oncology provider
- Plan for autologous transplantation for multiple myeloma
Additional Inclusion Criteria (One of the following must be met)
- Allergy to plerixafor
- Prior mobilization attempt was insufficient following filgrastim and plerixafor
Reproductive Health & Pregnancy Management
- For patients who can become pregnant: Pregnancy must be excluded prior to receiving motixafortide
- For patients who can become pregnant: Counseling provided on potential risks vs benefits of treatment and the use of effective contraception during therapy and for 8 days after stopping treatment