A prospective comparison of pegfilgrastim and lipegfilgrastim combined with chemotherapy in the mobilization of CD34 cells in NHL patients.

BACKGROUND

Autologous stem cell transplantation (auto-SCT) is a treatment approach in non-Hodgkin lymphoma (NHL) patients. The options for mobilization of CD34 cells to support high-dose therapy are granulocyte-colony stimulating factors (G-CSFs) alone or after chemotherapy. Limited data exist on the efficacy of lipegfilgrastim (LIPEG) in the mobilization field.

PATIENTS AND METHODS

The present prospective nonrandomized study compared LIPEG 6 mg (n = 40) with pegfilgrastim (PEG) 6 mg (n = 37) in the mobilization of blood CD34 cells after chemotherapy in NHL patients with comparable mobilizing chemotherapy and disease status before auto-SCT.

RESULTS

Significantly higher blood CD34 cell (B-CD34 ) counts were observed in the LIPEG group at the start of the first apheresis (44 vs 23 × 10 /L, P = .009), in line with a higher collection yield of the first apheresis (3.3 vs 2.1 × 10 /kg, P = .086) and total yield of CD34 cells (4.7 vs 2.9 × 10 /kg, P = .004). LIPEG proved to be a more effective G-CSF, resulting in a higher B-CD34 cell peak (60 vs 32 × 10 /L, P = .030) and higher proportion of excellent mobilizers (33% vs 8%, P = .008). The superiority of LIPEG was confirmed in the multivarite analysis concerning the CD34 cell yield of the first apheresis day (P = .010) and the total yield (P = .001).

CONCLUSION

The mobilization of blood grafts with LIPEG added to chemotherapy was associated with higher CD34 cell apheresis yields than with PEG. A randomized study is warranted to verify these findings.