A randomised study comparing peripheral blood progenitor mobilisation using intermediate-dose cyclophosphamide plus lenograstim with lenograstim alone

The VAD chemotherapy regimen plus a G-CSF dose of 10 μg/kg is as effective and less toxic than high-dose cyclophosphamide plus a G-CSF dose of 5 μg/kg for progenitor cell mobilization: results from a monocentric study of 82 patients

“…Growth factor alone can also mobilize a sufficient number of CD34 þ cells for a majority of MM patients, but controlled studies suggest that CY plus GM-CSF or G-CSF is more effective in stem cell mobilization than G-CSF alone. [19][20][21] In our study, the VAD plus G-CSF mobilization regimen was well tolerated, with neither admission for febrile neutropenia nor blood transfusion requirement, whereas HD-CY regimen was associated with a significant higher incidence of adverse effects requiring hospitalization, such as infections, fever, cytopenias and frequent transfusion support (Table 4). Moreover, HD-CY administration requires a systematic hospitalization for 3 consecutive days, whereas VAD could be administered in an ambulatory fashion for a large majority of patients, thereby allowing less discomfort and providing subsequent savings in terms of economical cost.…”

review: Current status of stem cell mobilization

“…A prospective randomized study to compare the efficacy of outpatient mobilization using cyclophosphamide 2 g/m 2 and lenograstim at 5 μg/kg was compared to lenograstim alone at 10 μg/kg. The use of lenograstim at 10 μg/kg was as efficient at mobilizing progenitor cells as a combination of cyclophosphamide and GCSF with reduced hospitalization and side effects (Karanth et al , 2004). In one report, the use of lenograstim provided superior mobilization more effectively than filgrastim in males but not in females.…”

Peripheral blood stem cell mobilization by granulocyte colony-stimulating factor alone and engraftment kinetics following autologous transplantation in children and adolescents with solid tumor

“…Methods for PBSC mobilization that are available for cancer patients include chemotherapy-induced mobilization, and mobilization by hematopoietic growth factor with or without chemotherapy. [5][6][7][8] Although chemotherapy plus granulocyte colony-stimulating factor (G-CSF) is a standard mobilization regimen for patients with cancer, 9 there is great variability in predicting the optimal day to start collecting PBSC. In particular, it takes longer to reach the peak of circulating CD34 þ cells following pre-mobilization chemotherapy, especially in heavily pre-treated patients.…”