A prospective comparison of pegfilgrastim and lipegfilgrastim combined with chemotherapy in the mobilization of CD34+ cells in NHL patients

J Clin Apher. 2020 Aug;35(4):255-263. doi: 10.1002/jca.21785. Epub 2020 Apr 20.

Abstract

Background: Autologous stem cell transplantation (auto-SCT) is a treatment approach in non-Hodgkin lymphoma (NHL) patients. The options for mobilization of CD34+ cells to support high-dose therapy are granulocyte-colony stimulating factors (G-CSFs) alone or after chemotherapy. Limited data exist on the efficacy of lipegfilgrastim (LIPEG) in the mobilization field.

Patients and methods: The present prospective nonrandomized study compared LIPEG 6 mg (n = 40) with pegfilgrastim (PEG) 6 mg (n = 37) in the mobilization of blood CD34+ cells after chemotherapy in NHL patients with comparable mobilizing chemotherapy and disease status before auto-SCT.

Results: Significantly higher blood CD34+ cell (B-CD34+ ) counts were observed in the LIPEG group at the start of the first apheresis (44 vs 23 × 106 /L, P = .009), in line with a higher collection yield of the first apheresis (3.3 vs 2.1 × 106 /kg, P = .086) and total yield of CD34+ cells (4.7 vs 2.9 × 106 /kg, P = .004). LIPEG proved to be a more effective G-CSF, resulting in a higher B-CD34+ cell peak (60 vs 32 × 106 /L, P = .030) and higher proportion of excellent mobilizers (33% vs 8%, P = .008). The superiority of LIPEG was confirmed in the multivarite analysis concerning the CD34+ cell yield of the first apheresis day (P = .010) and the total yield (P = .001).

Conclusion: The mobilization of blood grafts with LIPEG added to chemotherapy was associated with higher CD34+ cell apheresis yields than with PEG. A randomized study is warranted to verify these findings.

Keywords: CD34+ cell mobilization; hematological recovery; lipegfilgrastim; non-Hodgkin lymphoma; pegfilgrastim.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antigens, CD34 / biosynthesis*
  • Antineoplastic Agents / administration & dosage*
  • Blood Component Removal
  • Female
  • Filgrastim / administration & dosage*
  • Granulocyte Colony-Stimulating Factor / metabolism
  • Hematopoietic Stem Cell Mobilization / methods
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polyethylene Glycols / administration & dosage*
  • Prospective Studies
  • Stem Cell Transplantation
  • Transplantation, Autologous

Substances

  • Antigens, CD34
  • Antineoplastic Agents
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Filgrastim