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

Abstract

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 × 10⁶/L, P = .009), in line with a higher collection yield of the first apheresis (3.3 vs 2.1 × 10⁶/kg, P = .086) and total yield of CD34⁺ cells (4.7 vs 2.9 × 10⁶/kg, P = .004). LIPEG proved to be a more effective G‐CSF, resulting in a higher B‐CD34⁺ cell peak (60 vs 32 × 10⁶/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.