Pegylated Filgrastim vs. Filgrastim for Stem Cell Mobilization in Multiple Myeloma after Novel Agent Induction

This study focuses on the efficacy of pegfilgrastim in PBSC mobilization compared to filgrastim exclusively after novel agent-based induction in a homogeneous group of MM patients. We analyzed 89 patients with MM treated at two transplant centers in Singapore who received novel agent-based induction chemotherapy, PBSC mobilization with vinorelbine / cyclophosphamide, high-dose melphalan conditioning and autologous stem cell rescue. 61 patients were included in the pegfilgrastim group and 28 in the filgrastim group, with a similar median age and disease characteristics. PBSC harvesting was done at a similar median time of 9.51 days (SD = 0.84) for both and the peak peripheral blood CD34+ SC count was 19.90 x 106/kg for pegfilgrastim and 32.50 x 106/kg for filgrastim (95% CI = -4.36 to 0.70). There was no significant difference in the median PBSC collection between the 2 groups (pegfilgrastim: 7.90 x 106/kg vs. filgrastim: 10.10 x 106/kg P=0.16). This study demonstrates that a single dose of pegfilgrastim is comparable to filgrastim in terms of the timing and efficacy of PBSC harvest and could potentially spare the patient of six days of filgrastim injections. In addition, this is also the first study to compare these growth factors using vinorelbine / cyclophosphamide as mobilization chemotherapy.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research