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Mobilization of peripheral blood stem cells in myeloma with either pegfilgrastim or filgrastim following chemotherapy

¹ Division of Hematology and Blood and Bone Marrow Transplantation, University of Utah School of Medicine, Salt Lake City, UT, USA
² The Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
³ The Cancer Research and Biostatistics, Seattle, WA, USA
⁴ Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Correspondence: Guido Tricot, MD, PhD, The University of Utah School of Medicine, 30N 1900E, 5C402,Salt Lake City, UT 84132 USA. E-mail :guido.tricot{at}hsc.utah.edu

ABSTRACT

Quality and quantity of mobilized peripheral blood stem cells determine the safety of tandem autologous transplants in myeloma. Using the same mobilization chemotherapy with DT-PACE in two consecutive protocols, robustness of stem cell collection and rapidity of engraftment after transplantation were assessed. We employed either twice a day filgrastim versus two doses of pegfilgrastim. Advantages of pegfilgrastim were: (i) a higher percentage of patients collected 15x10⁶/kg in the first 3 days (p<0.001); (ii) the median number of CD34 cells/kg collected on day 1 was higher (p=0.004 ); (iii) the median number of growth factor injections was 2 versus 26 (p<0.0001); (iv) post-transplantation neutrophil recovery was faster after first and second transplant (p<0.001) and (v) platelet recovery was faster after first transplant (when less stem cells were infused) (p=0.01). Pegfilgrastim may be considered the standard of care for stem cell mobilization.

Key words: stem cells-mobilization-myeloma-pegfilgrastim.