Reduced dose of lenograstim is as efficacious as standard dose of filgrastim for peripheral blood stem cell mobilization and transplantation: A randomized study in patients undergoing autologous peripheral stem cell transplantation

Abstract

In vitro studies have demonstrated a 27% increased efficacy of lenograstim over filgrastim. However, equal doses of 10 lg/kg/day of filgrastim and lenograstim have been recommended for mobilization of CD341 cells without associated chemotherapy. In this study, we investigated whether a 25% reduced dose of lenograstim at 7.5 lg/kg/day is equavalent to 10 lg/kg/day filgrastim for autologous peripheral blood stem cell (PBSC) mobilization and transplantation. A total of 40 consecutive patients were randomized to either filgrastim (n 5 20) or lenograstim (n 5 20). The two cohorts were similar in regard to disease, sex, body weight, body surface area, conditioning regimens, previous chemotherapy cycles and radiotherapy. Each growth factor was administered for 4 consecutive days. The first PBSC apheresis was done on the 5th day. In the posttransplant period, the same G-CSF was given at 5 lg/kg/day until leukocyte engraftment. Successful mobilization was achieved in 95% of patients. Successful mobilization with the first apheresis, was achieved in 10/20 (50%) patients in the filgrastim group versus 9/20 (46%) patients in the lenograstim group. No significant difference was seen in the median number of CD341cells mobilized, as well as the median number of apheresis, median volume of apheresis, percentage of CD341 cells, and CD341 cell number. Leukocyte and platelet engraftments, the number of days requiring G-CSF and parenteral antibiotics, the number of transfusions were similar in both groups in the posttransplant period. Lenograstim 7.5 lg/kg/day is as efficious as filgrastim 10 lg/kg/day for autologous PBSC mobilization and transplantation. Am. J. Hematol. 83:644-648, 2008. V

Comparison between filgrastim and lenograstim plus chemotherapy for mobilization of PBPCs

“…Despite these differences, Kopf et al evidenced a more rapid mobilization in patients receiving lenograstim (day median number ¼ 12) than in those receiving filgrastim (day median number ¼ 13), which is in line with our results. The randomized study by Ataergin et al 37 on patients with solid and hematological tumors agrees with our results, as it indicates that a lower dose of glycosylated G-CSF is as effective as the standard dose of non-glycosylated G-CSF for PBPC mobilization in patients undergoing auto-SCT.…”

Inductive Potential of Recombinant Human Granulocyte Colony-Stimulating Factor to Mature Neutrophils from X-Irradiated Human Peripheral Blood Hematopoietic Progenitor Cells

“…17,18) Furthermore, 25% reduction in the dose of Lenograstim (7.5 mg/kg/d) has an efficacy equivalent to 10 mg/kg/d of Filgrastim for autologous peripheral blood stem cell mobilization and transplantation. 19) Our results showed that ROS production by Lenograstim-induced mature neutrophils is higher than that by Filgrastim-induced mature neutrophils (Fig. 6B).…”

“…Although many reports compare and analyze these three types of rhGCSFs, [15][16][17][18][19] it remains unknown whether recovery from hematopoietic injuries by ionizing radiation depends on the type of rhG-CSF. In this study, we investigated the effects of these three different types of rhG-CSFs on human granulocyte progenitor cells and expansion of neutrophils from nonirradiated or X-irradiated human CD34 ϩ hematopoietic progenitor cells.…”

Comparison of Filgrastim and Lenograstim in Pediatric Solid Tumors

“…Ria et al [18] found that lenograstim achieved the collection target more rapidly and with decreased leukapheresis compared with filgrastim using the same dose (10 μg/kg/day). Ataergin et al [26] found that 7.5 μg/kg/day lenograstim was as efficient as 10 μg/kg/day filgrastim. However, Kim et al [27] concluded that filgrastim significantly reduced the duration of neutropenia, thrombocytopenia, and days of G-CSF administration compared with lenograstim in patients undergoing peripheral blood stem cell transplantation.…”