Fixed‐dose single agent pegfilgrastim for peripheral blood progenitor cell mobilisation in patients with multiple myeloma

Abstract

Summary High‐dose chemotherapy and autologous peripheral blood progenitor cell transplantation is an effective treatment for multiple myeloma. Progenitor cells are generally mobilised into the peripheral blood by administration of filgrastim. Pegfilgrastim is a covalent conjugate of filgrastim with a longer half‐life. The results of a phase II study of pegfilgrastim, administered as a single injection to mobilise autologous peripheral blood progenitor cells in patients with multiple myeloma, is reported. All patients (n = 19) received 12 mg of pegfilgrastim. Leukaphaeresis was started when the peripheral blood CD34+ count was >0·015 × 109/l. Daily, leukaphaeresis was performed until the target progenitor cell dose was obtained. The median number of leukaphaeresis procedures required to collect the target CD34+ cell dose was 2 (range 1–5). A median of 8·4 × 106 CD34+ cells/kg (range 4·1–15·8) was collected. The most common toxicity was bone pain/myalgia. Sustained haematological recovery occurred in all the patients who underwent high‐dose chemotherapy followed by autologous peripheral blood progenitor cell transplantation with pegfilgrastim‐mobilised cells. A single fixed dose of pegfilgrastim was effective in mobilising adequate peripheral blood progenitor cells in patients with multiple myeloma. The efficacy and toxicity profile was similar to that described with filgrastim treatment.

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

“…In patients with lymphomas, a single 6-mg dose of PEGFIL resulted in adequate mobilization of stem cells and sufficient yield after only one apheresis cycle in the majority of patients, including previously treated patients who were possibly poor mobilizers [11,12,20]. In patients with myeloma, PEGFIL at doses of 6-12 mg [10,13,21,22] has been used successfully for stem cell mobilization. The 6-mg dose was shown to be as efficient as the 12-mg dose [13], and mobilization efficacy and harvesting outcomes were comparable between the single-dose PEGFIL and daily FIL groups [10,13,22].…”

Efficient mobilization of peripheral blood stem cells following CAD chemotherapy and a single dose of pegylated G-CSF in patients with multiple myeloma

“…[8][9][10] The results of other recent studies support the feasibility of pegfilgrastim mobilization regimens for a variety of other malignancies as well. [11][12][13][14][15] The present study evaluated the efficacy of a single dose of pegfilgrastim in mobilizing PBSC following myeloablative chemotherapy in patients with stage II and III myeloma.…”

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

“…Hosing et al 31 demonstrated the efficacy of 12 mg pegfilgrastim-alone for mobilization in 19 patients with myeloma, and included data from 8 patients mobilized with filgrastim-alone, because they were not eligible for pegfilgrastim, mostly because of enlarged spleen at baseline. The numbers in this study were, however, too small to draw any comparisons between these two approaches in terms of mobilization efficacy.…”

“…28 Less has been published regarding the use of pegfilgrastim without chemotherapy for HSPC mobilization. Data comparing pegfilgrastim mobilization to filgrastim-alone mobilization is particularly scarce, with five published reports [29][30][31][32][33] and one unpublished trial by Amgen in 2005; only two of the published reports are in autologous adult mobilization, 31,32 neither of which is a truly comparative study. In this retrospective analysis, we present data comparing pegfilgrastim versus filgrastim in terms of mobilization kinetics and efficiency in 52 patients with haematological malignancy undergoing cytokine-only mobilization.…”