Pegfilgrastim improves the outcomes of mobilization and engraftment in autologous hematopoietic stem cell transplantatio

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ORIGINAL ARTICLE

Pegfilgrastim improves the outcomes of mobilization and engraftment in autologous hematopoietic stem cell transplantation for the treatment of multiple myeloma Xiao Ding 1 & Wenyang Huang 2 & Yi Peng 1 & Hongqiong Fan 1 & Yingqiao Zhu 1 & Xuelian Liu 1 & Yanping Yang 1 & Qiang Guo 1 & Lugui Qiu 2 & Yun Dai 3 & Dehui Zou 2,4 & Fengyan Jin 1 Received: 29 April 2019 / Accepted: 11 September 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019

Abstract Autologous stem cell transplantation (ASCT) is the only curable therapy for multiple myeloma (MM), while its success primarily relies on mobilization to obtain sufficient hematopoietic stem/progenitor cells (HPC). Although the role of Pegfilgrastim (PEG), a novel PEGylated form of the recombinant G-CSF filgrastim (FIL), in mobilization has been demonstrated, it remains unclear whether this approach is cost-effective in MM treatment. Here, we performed a real-world analysis to evaluate the efficacy and cost of PEG for mobilization in a cohort of MM patients, of which 53% carried high-risk cytogenetic abnormalities. A total of 91 patients who received either a single dose of PEG (6 or 12 mg, n = 42) or multiple dosing of 10 μg/kg/day FIL (n = 49) after chemotherapy for HPC mobilization were included. The yield of MNCs and CD34+ cells per milliliter of blood collected via apheresis was significantly greater in the PEG group than that in the FIL group (P = 0.014 and P = 0.038). Mobilization with PEG yielded significantly higher median number of collected CD34+ cells than FIL (5.56 vs. 4.82 × 106/kg; P = 0.038). Moreover, the average time-to-recovery of leukocytes and platelets after transplantation was markedly shorter in the PEG group than that in the FIL group (leukocyte, 11.59 ± 1.98 vs 12.93 ± 2.83 days, P = 0.019; platelet, 12.86 ± 2.62 vs 14.80 ± 5.47, P = 0.085). However, the total cost of mobilization and apheresis using PEG or FIL was comparable (P = 0.486). Of note, mobilization with 12 mg PEG further shortened time-to-recovery of leukocytes (10.64 ± 0.51 vs. 12.04 ± 2.26 days, P = 0.05) and platelets (10.60 ± 2.89 vs. 13.33 ± 2.35 days, P = 0.031) compared with 6 mg PEG. Our results support a notion that PEG (especially 12 mg) combined with chemotherapy is a cost-effective and convenient regimen of mobilization, which might improve the outcome of ASCT in MM.

Xiao Ding and Wenyang Huang contributed equally to this work. * Yun Dai [email protected] * Dehui Zou [email protected] * Fengyan Jin [email protected] 1

Cancer Center, the First Hospital of Jilin University, Changchun, Jilin, China

2

State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin, China

3

Laboratory of Cancer Precision Medicine, the First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, China

4

Department of Lymphoma, Blood Diseases Hospital and Institute of Hematology, CAMS, 288 Nanjing Road, Tianjin, China

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