Filgrastim, lenograstim and pegfilgrastim in the mobilization of peripheral blood progenitor cells in patients with lymphoproliferative malignancies

Clin Exp Med. 2015 May;15(2):145-50. doi: 10.1007/s10238-014-0282-9. Epub 2014 Apr 11.

Abstract

Patients with lymphoproliferative disorders, candidate to autologous stem cell transplantation (ASCT), require mobilization with chemotherapy and granulocyte colony -stimulating factor (G-CSF). This study looked for differences in hematopoietic peripheral stem cells (HPSCs) mobilization in response to the three available G-CSFs, namely lenograstim, filgrastim, and pegfilgrastim. Between 2000 and 2012, 146 patients (66 M and 80 F) who underwent ASCT for multiple myeloma, non-Hodgkin's lymphoma or Hodgkin's lymphoma were studied. All patients received induction therapy and then a mobilization regimen with cyclophosphamide plus lenograstim, or filgrastim, or pegfilgrastim. From days 12 to 14, HPSCs were collected by two to three daily leukaphereses. Our results show that high-dose cyclophosphamide plus lenograstim achieved adequate mobilization and the collection target more quickly and with fewer leukaphereses as compared to filgrastim and pegfilgrastim. No differences between the three regimens were observed regarding toxicity and days to WBC and platelet recovery. Thus, lenograstim may represent the ideal G-CSF for PBSC mobilization in patients with lymphoproliferative diseases. Further studies are needed to confirm these results and better understand the biological bases of these differences.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cyclophosphamide / administration & dosage
  • Female
  • Filgrastim / administration & dosage*
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Hematopoietic Cell Growth Factors / administration & dosage*
  • Hematopoietic Stem Cells / drug effects*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Lenograstim
  • Lymphoma / drug therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Polyethylene Glycols
  • Recombinant Proteins / administration & dosage
  • Treatment Outcome

Substances

  • Hematopoietic Cell Growth Factors
  • Immunosuppressive Agents
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Lenograstim
  • Cyclophosphamide
  • Filgrastim