Pegfilgrastim for peripheral CD34+ mobilization in patients with solid tumours

Willis, Fenella; Woll, Penella J.; Theti, Davinder S.; Jamali, H; Bacon, Pamela; Baker, Nigel; Pettengell, Ruth

doi:10.1038/bmt.2008.411

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…[10][11][12][13] More recently, comparative clinical studies of pegfilgrastim and non-pegylated G-CSF in combination with chemotherapy for PBSC mobilization in auto-HSCT patients have been performed. Although some have demonstrated that the use of pegfilgrastim results in an earlier apheresis start and reduction in the number of apheresis procedures required for PBSC collection, others have failed to show such a benefit.…”

Section: Introductionmentioning

confidence: 99%

Pegfilgrastim vs filgrastim in PBSC mobilization for autologous hematopoietic SCT: a systematic review and meta-analysis

Kim

Han

Lee

et al. 2015

Bone Marrow Transplant

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Section: Introductionmentioning

confidence: 99%

Pegfilgrastim vs filgrastim in PBSC mobilization for autologous hematopoietic SCT: a systematic review and meta-analysis

Kim

Han

Lee

et al. 2015

Bone Marrow Transplant

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“…There was a trend of higher number of cells harvested per leukopheresis and higher proportion of patients achieved minimal target of CD34+ cells ≥2 × 10 6 /kg in the daily filgrastim arm (n = 32) as compared to pegfilgrastim 6 mg (n = 29), which was not statistically significant. Willis et al [7] compared daily filgrastim 5 μg/kg/day versus pegfilgrastim 6 mg, 12 mg or 18 mg administered on day 2 after carboplatin and paclitaxel. The peak peripheral blood CD34+ cell count and the proportion of patients achieved the target peak peripheral blood CD34+ cells of >20/μl were higher in daily filgrastim (n = 14) arm as compared to pegfilgrastim 6 mg (n = 16) arm although the result was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…However, there were very few randomized trials comparing the effectiveness of filgrastim and pegfilgrastim in PBSC mobilization [3][4][5][6][7][8][9]. There was no clinical trial comparing the timing of pegfilgrastim against successful PBSC mobilization despite the concern that early administration of pegfilgrastim after chemotherapy (CT) will reduce the optimal drug level (as the chemotherapy-induced neutropenia has not set in) which could affect the mobilization.…”

Section: Introductionmentioning

confidence: 99%

A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization

Kuan

Wong

et al. 2015

Transfusion and Apheresis Science

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There are few randomized trials comparing filgrastim and pegfilgrastim in peripheral blood stem cell mobilization (PBSCM). None of the trials studied the effects of the timing of pegfilgrastim administration on the outcomes of mobilization. We conducted a randomized triple blind control trial comparing the outcomes of filgrastim 5 µg/kg daily from day 3 onwards, 'early' pegfilgrastim 6 mg on day 3 and 'delayed' pegfilgrastim 6 mg on day 7 in cyclophosphamide PBSCM in patients with no previous history of mobilization. Peripheral blood (PB) CD34+ cell count was checked on day 8 and day 11 onward. Apheresis was started when PB CD34+ ≥ 10/µl from day 11 onward. The primary outcome was the successful mobilization rate, defined as cumulative collection of ≥ 2 × 10(6)/kg CD34+ cells in three or less apheresis. The secondary outcomes were the day of neutrophil and platelet engraftment post transplantation. There were 156 patients randomized and 134 patients' data analyzed. Pegfilgrastim 6 mg day 7 produced highest percentage of successful mobilization, 34 out of 48 (70.8%) analyzed patients, followed by daily filgrastim, 28 out of 44 (63.6%) and day 3 pegfilgrastim, 20 out of 42 (47.6%) (p = 0.075). Pegfilgrastim day 7 and daily filgrastim reported 1.48 (p = 0.014) and 1.49 (p = 0.013) times higher successful mobilization rate respectively as compared to pegfilgrastim day 3 after adjusting for disease, gender and exposure to myelotoxic agent. Multiple myeloma patients were three times more likely to achieve successful mobilization as compared to acute leukemia or lymphoma patients. Pegfilgrastim avoided the overshoot of white cells compared to filgrastim. There was no difference in the duration of both white cells and platelet recovery post transplantation between the three interventional arms.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Herbert

Gambell

Link

et al. 2012

Bone Marrow Transplant

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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 ¼ 20) or 6 mg (n ¼ 2) was administered Day 1 (D1) in 22 patients (lymphoma n ¼ 17; myeloma n ¼ 5). Thirty historical controls (lymphoma n ¼ 18; myeloma n ¼ 12) received filgrastim 10 mcg/kg daily from D1. Peripheral blood (PB) CD34 þ counts reached threshold (X5 Â 10 6 /L) and apheresis commenced on D4(4-5) and D4(4-6). Median PB CD34 þ cell count on D1 of apheresis was similar (26.0 Â 10 6 /L (2.5-125.0 Â 10 6 /L) and 16.2 Â 10 6 /L (2.6-50.7 Â 10 6 /L); P ¼ 0.06), for pegfilgrastim and filgrastim groups, respectively. Target yield (X2 Â 10 6 per kg CD34 þ cells) was collected in 20/22 (91%) pegfilgrastim patients and 24/30 (80%) in the filgrastim group (P ¼ 0.44), in a similar median number of aphereses (3(1-4) versus 3(2-6), respectively; P ¼ 0.85). A higher proportion of pegfilgrastim patients tended to yield X4 Â 10 6 per kg CD34 þ cells; 16/22 (73%) versus 14/30 (47%) filgrastim patients (P ¼ 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. (2013) 48, 351-356; doi:10.1038/bmt.2012.145; published online 30 July 2012 Bone Marrow TransplantationKeywords: CD34; pegfilgrastim; mobilization; filgrastim; autologous transplantation INTRODUCTIONThe emergence of recombinant human cytokines for the mobilization of haematopoietic stem and progenitor cells (HSPC) is one of the critical milestones in the history of haematopoietic SCT. The isolation and purification of G-CSF (filgrastim) and the discovery of its potent effect in mobilizing stem and progenitor cells into the PB has provided an alternative to harvesting BM as a source of HSPC for transplantation. Indeed, transplantation using mobilized PB HSPC has been found to result in superior engraftment rates than BM-derived HSPC for transplantation, especially with respect to platelet recovery. 1,2 HSPC mobilization is routinely achieved either using cytokine-alone or cytokine following myelosuppressive chemotherapy (chemo-cytokine mobilization).Chemo-cytokine mobilization results in superior HSPC yields overall, 3-5 however there is increasing interest in outpatient-based cytokine-only regimens for mobilization owing to the improved acceptability to patients, the absence of risk of neutropenic complications and possibly more predictable mobilization kinetics compared with chemo-cytokine mobilization. In chemo-cytokine mobilization, the cytokine effect of filgrastim makes use of the wave of i...

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Pegfilgrastim for peripheral CD34+ mobilization in patients with solid tumours

Cited by 14 publications

References 21 publications

Pegfilgrastim vs filgrastim in PBSC mobilization for autologous hematopoietic SCT: a systematic review and meta-analysis

Pegfilgrastim vs filgrastim in PBSC mobilization for autologous hematopoietic SCT: a systematic review and meta-analysis

A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization

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

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