Pegfilgrastim compared with filgrastim for cytokine-Alone mobilization of autologous haematopoietic stem and progenitor cells

摘要

Haematopoietic stem and progenitor cells (HSPC) mobilization, using cytokine-Alone, is a well-tolerated regimen with predictable mobilization kinetics. Single-dose pegfilgrastim mobilizes HSPC efficiently; however, there is surprisingly little comparative data on its use without chemotherapy for HSPC mobilization. Pegfilgrastim-Alone and filgrastim-Alone mobilization regimens were compared in 52 patients with haematological malignancy. Pegfilgrastim 12 mg (n=20) or 6 mg (n=2) was administered Day 1 (D1) in 22 patients (lymphoma n=17; myeloma n=5). Thirty historical controls (lymphoma n=18; myeloma n=12) received filgrastim 10 mcg/kg daily from D1. Peripheral blood (PB) CD34+ counts reached threshold (??5 ?? 106/L) and apheresis commenced on D4(4-5) and D4(4-6). Median PB CD34+ cell count on D1 of apheresis was similar (26.0 ?? 106/L (2.5-125.0 ?? 10 6/L) and 16.2 ?? 106/L (2.6-50.7 ?? 10 6/L); P=0.06), for pegfilgrastim and filgrastim groups, respectively. Target yield (??2 ?? 106 per kg CD34+ cells) was collected in 20/22 (91%) pegfilgrastim patients and 24/30 (80%) in the filgrastim group (P=0.44), in a similar median number of aphereses (3(1-4) versus 3(2-6), respectively; P=0.85). A higher proportion of pegfilgrastim patients tended to yield ??4 ?? 106 per kg CD34+ cells; 16/22 (73%) versus 14/30 (47%) filgrastim patients (P=0.09). One pegfilgrastim patient developed hyperleukocytosis that resolved without incident. Pegfilgrastim-Alone is a simple, well-tolerated, and attractive option for outpatient-based HSPC mobilization with similar mobilization kinetics and efficacy to regular filgrastim. ? 2013 Macmillan Publishers Limited. All rights reserved.