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Single-dose pegfilgrastim is comparable to daily filgrastim in mobilizing peripheral blood stem cells: a case-matched study in patients with lymphoproliferative malignancies

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Abstract

Pegfilgrastim (PEGFIL) has been found to be comparable to daily filgrastim (FIL) in managing chemotherapy-induced neutropenia. In the present study, we evaluated the ability of PEGFIL to mobilize stem cells in 38 consecutive patients with lymphoproliferative diseases (multiple myeloma, n = 18; lymphomas, n = 15; chronic lymphocytic leukemia, n = 5). Patients were mobilized using PEGFIL (6–18 mg as a single dose) during 2005–2006; 32 then received high-dose chemotherapy followed by autologous stem cell transplantation. PEGFIL-mobilized patients were matched by age, disease, and treatment line at a ratio of 1:2 to historical FIL-mobilized controls. The primary study endpoint was the blood CD34+ concentration at onset of leukapheresis. Leukapheresis began a median of 10 days from the beginning of mobilization chemotherapy in both groups. At the onset of leukapheresis, median blood CD34+ cell counts did not differ significantly in the FIL group compared with the PEGFIL group (79 × 106/L vs 64 × 106/L, respectively; p = 0.44). In the different disease categories, the respective CD34+ cell counts after FIL and PEGFIL mobilization were 72 × 106/L vs 123 × 106/L (p = 0.08) in myeloma, 51 × 106/L vs 62 × 106/L (p = 0.6) in lymphomas, and 27 × 106/L vs 30 × 106/L (p = 0.62) in CLL, respectively. The target CD34+ cell yield was harvested with one leukapheresis in 53% of PEGFIL-mobilized patients. Engraftment after autografting did not differ significantly in the two groups. Stem cell mobilization with a single dose of PEGFIL was, therefore, comparable to that achieved using daily FIL in patients with lymphoproliferative diseases. PEGFIL is a more practical way to mobilize stem cells than daily FIL.

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Authors and Affiliations

  1. Department of Medicine, Turku University Central Hospital, PL 52, 20521, Turku, Finland

    Mervi Putkonen & Kari Remes

  2. Vaasa Central Hospital, Vaasa, Finland

    Auvo Rauhala

  3. Haematological Laboratory, TYKSLAB, Turku, Finland

    Tarja-Terttu Pelliniemi

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  1. Mervi Putkonen
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  2. Auvo Rauhala
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  3. Tarja-Terttu Pelliniemi
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  4. Kari Remes
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Correspondence to Mervi Putkonen.

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Putkonen, M., Rauhala, A., Pelliniemi, TT. et al. Single-dose pegfilgrastim is comparable to daily filgrastim in mobilizing peripheral blood stem cells: a case-matched study in patients with lymphoproliferative malignancies. Ann Hematol 88, 673–680 (2009). https://doi.org/10.1007/s00277-008-0675-5

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