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Stem Cell Procurement

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

Bone Marrow Transplantation volume 48, pages 351–356 (2013)Cite this article

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Abstract

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 × 106/L) and 16.2 × 106/L (2.6–50.7 × 106/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.

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Acknowledgements

KEH is supported by Cancer Council of Victoria Early Career Clinician Researcher Fellowship.

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Authors and Affiliations

  1. Department of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

    K E Herbert, S J Harrison, D S Ritchie, J F Seymour & H M Prince

  2. Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

    P Gambell, A Mouminoglu & D M Wall

  3. Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

    E K Link

  4. Centre for Blood Cell Therapies, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia

    K E Herbert, P Gambell, A Mouminoglu, D M Wall, S J Harrison, D S Ritchie & H M Prince

  5. University of Melbourne, Parkville, Victoria, Australia

    K E Herbert, S J Harrison, D S Ritchie, J F Seymour & H M Prince

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Correspondence to K E Herbert.

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KEH is a recipient of a Cancer Council of Victoria Early Career Clinician Researcher Fellowship. Professor Prince has received lecture fees and research funding from Amgen Inc. The remaining authors declare no conflict of interest.

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Herbert, K., Gambell, P., Link, E. et al. Pegfilgrastim compared with filgrastim for cytokine-alone mobilization of autologous haematopoietic stem and progenitor cells. Bone Marrow Transplant 48, 351–356 (2013). https://doi.org/10.1038/bmt.2012.145

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