Mobilization of hematopoietic progenitor cells with granulocyte colony stimulating factors for autologous transplant in hematologic malignancies

Abstract

BackgroundIn 2006 the Hematology Service of Hospital Maciel published its experience with peripheral blood progenitor cell harvesting for autologous stem cell transplantation using Filgen JP (Clausen Filgrastim). After mobilization with a mean filgrastim dose of 78 mcg/Kg, 4.7 x 106 CD34+ cells/Kg were obtained by apheresis. Age above 50, multiple myeloma as underlying disease and a malignancy that was not in remission were identified as frequent characteristics among patients showing complex mobilization.ObjectiveThe aim of this study was to compare stem cell mobilization using different brands of filgrastim.MethodsOne hundred and fifty-seven mobilizations performed between 1997 and 2006 were analyzed. This retrospective analysis comparative two groups of patients: those mobilized with different brands of filgrastim (Group A) and those who received Filgen JP (Clausen Filgrastim) as mobilizing agent (Group B). A cluster analysis technique was used to identify four clusters of individuals with different behaviors differentiated by age, total dose of filgrastim required, number of apheresis and harvested CD34+ cells.ResultsThe mean total dose of filgrastim administered was 105 mcg/Kg, the median number of apheresis was 2 procedures and the mean number of harvested stem cells was 4.98 x 106 CD34+ cells/Kg. No significant differences were observed between Groups A and B regarding the number of apheresis, harvested CD34+ cells and number of mobilization failures, however the total dose of filgrastim was significantly lower in Group B.ConclusionsAmong other factors, the origin of the cytokine used as mobilizing agent is an element to be considered when evaluating CD34+ cell mobilization results.

Filgrastim Biossimilar para Mobilização de Células Progenitoras antes do Transplante Autólogo: Análise Retrospectiva de Pacientes com Mieloma Múltiplo e Linfomas

“…Gabús et al reported on their experience with PBPC harvesting for autologous transplantation using another filgrastim biosimilar, Filgen JP (Clausen Filgrastim), as well as other filgrastim products available in Uruguay. 15 There was no difference in effectiveness between Filgen JP and other filgrastim products, and the mean number of CD34+ cells harvested in that study was 4.98 x 10 6 CD34+ cells/Kg, almost twice as high as the mean number found in the current study (2.84 x 10 6 CD34+ cells/Kg). The reason for this difference is not entirely clear.…”

“…Previous studies have shown that the use of biosimilar filgrastim offers cost savings with similar efficacy when compared to the innovator product 17,18 . These findings and the apparent lack of differences in activity or safety between the innovator and biosimilar filgrastim products 4,[8][9][10][11]15 support the use of biosimilar filgrastim in clinical practice.…”

Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations

“…Several studies carried out to investigate this question showed that the diagnosis of lymphoma, [14][15][16][17][18][19] thrombocytopenia, 14,[20][21][22][23] older age [18][19][20][21][23][24][25] and polytreatment 14,16,19,25,26 , among other factors, emerged as the main potential factors for the prediction of poor recruitment of hematopoietic stem cells.…”

Peripheral hematopoietic progenitor cell mobilization for autologous transplantation in hematologic malignancies

“…In this issue of the Revista Brasileira de Hematologia e Hemoterapia , Gabús et al ( 1 ) are publishing an interesting article about hematopoietic progenitor cell mobilization for autologous transplantation in hematologic malignancies. Although the analysis was retrospective, they utilized the abundant statistical tools and compared two successive groups of patients with similar numbers and over similar periods, in order to compare patients in respect to the origin of the growth factor used, different brands in the first group and a specific growth factor (JP Filgen - Clausen filgrastim) in the second.…”

“…Following that, in a study published in 2006, ( 3 ) we analyzed other parameters to predict the ideal time to start apheresis, in order to reduce the number of procedures. At that time, we began to use the same guideline that Gabús et al, ( 1 ) i.e., when the CD34 + count in peripheral blood reached 10 cells/mm 3 . We were able to demonstrate, through sequential daily blood cell and CD34 + counts, that the best day can be predicted by a formula that considers hemoglobin on the day of mobilization chemotherapy and the number of days between chemotherapy mobilization and when the CD34 + cell count in peripheral blood reached 10 cells/mm 3 .…”