Filgrastim-alone versus pegylated filgrastim-alone for autologous peripheral blood stem cells mobilization in newly diagnosed multiple myeloma patients

Skopec, Barbara; Škerget, Matevž; Žontar, Darja; Zadnik, Vesna; Zver, Samo

doi:10.1007/s00508-017-1205-z

Cited by 8 publications

(6 citation statements)

References 33 publications

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“…Other trials and retrospective analyses have indicated that PEG is at least as effective as FIL in either growth factor-only auto-HPC mobilization [31,32] or in the context of chemotherapy mobilization [33,34]. Our study differs from some other PEG-containing mobilization studies [18,19,31,32], using a lower dose of PEG (6 mg versus 12 mg) impacting the cost comparison of PEG and FIL. The other difference is that our study strictly used growth factor and plerixafor mobilization and not chemotherapy mobilization as in previous reports [20][21][22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 81%

“…A subsequent analysis found similar performance of PEG 12 mg versus PEG 6 mg and lower cost associated with the lower dose [30]. Other trials and retrospective analyses have indicated that PEG is at least as effective as FIL in either growth factor-only auto-HPC mobilization [31,32] or in the context of chemotherapy mobilization [33,34]. Our study differs from some other PEG-containing mobilization studies [18,19,31,32], using a lower dose of PEG (6 mg versus 12 mg) impacting the cost comparison of PEG and FIL.…”

Section: Discussionmentioning

confidence: 90%

“…TBO has been shown to have similar performance to and lower cost than FIL in auto-HPC mobilization [27]. Although this assumption is itself a limitation, the literature [18,19,30,31,33,34] supports that the performance of PEG is at least equivalent to, if not superior to, that of FIL or TBO. Any superiority of PEG would translate into the need for fewer collections in some patients and fewer doses of plerixafor, and consequently would favor PEG in a cost analysis with FIL or TBO.…”

Section: Discussionmentioning

confidence: 99%

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Mobilization of Hematopoietic Progenitor Cells for Autologous Transplantation Using Pegfilgrastim and Plerixafor: Efficacy and Cost Implications

Watts

Marques

Peavey

et al. 2019

Biology of Blood and Marrow Transplantation

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Filgrastim (FIL) is the most common growth factor combined with plerixafor for autologous hematopoietic progenitor cell mobilization, but requires daily, multi-injection administration. We adopted a standardized mobilization regimen with pegfilgrastim (PEG) and upfront plerixafor, allowing for a single injection given the long half-life and slow elimination of PEG. Between 2015 and 2017, a total of 235 patients with lymphoma or plasma cell dyscrasias underwent mobilization with PEG 6 mg on day 1 and upfront plerixafor 24 mg on day 3, followed by apheresis on day 4 regardless of peripheral blood CD34 cells. The median CD34 cells/mm in peripheral blood on first day of collection was 48 and median collection yield was 7.27 × 10 CD34 cells/kg (range, 0.32 to 39.6 × 10 CD34 cells/kg) after a mean of 1.6 apheresis collections. Overall, 83% of patients achieved the mobilization target, and 95% reached the minimum necessary CD34 cell yield to proceed with transplantation (2 × 10 CD34 cells/kg). Because FIL is weight-based and dosed daily, the cost comparison with PEG is influenced by patient weight and number of apheresis sessions required. A cost simulation using actual patient data indicates that PEG is associated with lower cost than FIL for the majority of patients. Autologous hematopoietic progenitor cell mobilization with PEG and plerixafor is practical, effective, and not associated with increased cost compared with FIL mobilization.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Mobilization of Hematopoietic Progenitor Cells for Autologous Transplantation Using Pegfilgrastim and Plerixafor: Efficacy and Cost Implications

Watts

Marques

Peavey

et al. 2019

Biology of Blood and Marrow Transplantation

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“…2012 Acute leukemia, MM or lymphoma CY + G-CSF RD; CY + Pegfilgrastim 6 mg on day 3 or day 7 Pegfilgrastim 6 mg on day 7 produced highest rate of successful mobilization Russell et al [ 56 ] Phase 2 RCT, double-blind, multicenter Feb. 2003–Sep. 2004 NHL ICE + G-CSF RD; ICE + Pegfilgrastim 6 mg or 12 mg No significant differences in the number of CD34 + cells collected and the rate of reaching optimal target Skopec et al [ 59 ] RCT, single center Feb. 2012–Nov. 2014 MM G-CSF SD; Pegfilgrastim 12 mg No significant difference in the number of CD34 + cells collected ( P = 0.428) Biosimilar G-CSF versus G-CSF Bhamidipati et al [ 25 ] Phase 2 RCT, open-label, single center Aug. 2014–Jun.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of hematopoietic stem cell mobilization regimens in patients with hematological malignancies: a systematic review and network meta-analysis of randomized controlled trials

Luo

Huang

et al. 2022

Stem Cell Res Ther

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Background Efficient mobilization of hematopoietic stem cells (HSCs) from bone marrow niche into circulation is the key to successful collection and transplantation in patients with hematological malignancies. The efficacy of various HSCs mobilization regimens has been widely investigated, but the results are inconsistent. Methods We performed comprehensive databases searching for eligible randomized controlled trials (RCTs) that comparing the efficacy of HSCs mobilization regimens in patients with hematological malignancies. Bayesian network meta-analyses were performed with WinBUGS. Standard dose of granulocyte colony-stimulating factor (G-CSF SD) was chosen as the common comparator. Estimates of relative treatment effects for other regimens were reported as mean differences (MD) or odds ratio (OR) with associated 95% credibility interval (95% CrI). The surface under the cumulative ranking curve (SUCRA) were obtained to present rank probabilities of all included regimens. Results Databases searching and study selection identified 44 eligible RCTs, of which the mobilization results are summarized. Then we compared the efficacy of mobilization regimens separately for patients with multiple myeloma (MM) and non-Hodgkin lymphoma (NHL) by including 13 eligible trials for network meta-analysis, involving 638 patients with MM and 592 patients with NHL. For patients with MM, data are pooled from 8 trials for 6 regimens, including G-CSF in standard dose (SD) or reduced dose (RD) combined with cyclophosphamide (CY), intermediate-dose cytarabine (ID-AraC) or plerixafor. The results show that compared with G-CSF SD alone, 3 regimens including ID-AraC + G-CSF SD (MD 14.29, 95% CrI 9.99–18.53; SUCRA 1.00), G-CSF SD + Plerixafor SD (MD 4.15, 95% CrI 2.92–5.39; SUCRA 0.80), and CY + G-CSF RD (MD 1.18, 95% CrI 0.29–2.07; SUCRA 0.60) are associated with significantly increased total number of collected CD34+ cells (× 106/kg), among which ID-AraC + G-CSF SD ranked first with a probability of being best regimen of 100%. Moreover, ID-AraC + G-CSF SD and G-CSF SD + Plerixafor SD are associated with significantly higher successful rate of achieving optimal target (collecting ≥ 4–6 × 106 CD34+ cells/kg). For patients with NHL, data are pooled from 5 trials for 4 regimens, the results show that compared with G-CSF SD alone, G-CSF SD + Plerixafor SD (MD 3.62, 95% CrI 2.86–4.38; SUCRA 0.81) and G-CSF SD plus the new CXC chemokine receptor-4 (CXCR-4) antagonist YF-H-2015005 (MD 3.43, 95% CrI 2.51–4.35; SUCRA 0.69) are associated with significantly higher number of total CD34+ cells collected. These 2 regimens are also associated with significantly higher successful rate of achieving optimal target. There are no significant differences in rate of achieving optimal target between G-CSF SD + Plerixafor SD and G-CSF + YF-H-2015005. Conclusions In conclusion, ID-AraC plus G-CSF is associated with the highest probability of being best mobilization regimen in patients with MM. For patients with NHL, G-CSF in combination with plerixafor or YF-H-2015005 showed similar improvements in HSCs mobilization efficacy. The relative effects of other chemotherapy-based mobilization regimens still require to be determined with further investigations.

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“…A total of 13 studies of FIL versus PEG-F were included (Supplementary Materials Table S9): 12 RCTs of CIN indication [8,9,19,[66][67][68][69][70][71][72][73][74] and 1 RCT of AML indication [75]. A total of 9 studies of FIL versus Bio-F were included (Supplementary Materials Table S10): 6 RCTs of CIN indication [76][77][78][79][80][81] and 3 observational studies of PBCL indication [82][83][84]. No studies evaluating FIL versus PCT/NT in HSARS indication met the eligibility criteria for data extraction.…”

Section: Description Of Studiesmentioning

confidence: 99%

Efficacy and Safety of Filgrastim and Its Biosimilars to Prevent Febrile Neutropenia in Cancer Patients: A Prospective Study and Meta-Analysis

Rastogi

Kalaiselvan

Ali

et al. 2021

Biology

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Background: The aim of this review and meta-analysis was to identify, assess, meta-analyze and summarize the comparative effectiveness and safety of filgrastim in head-to-head trials with placebo/no treatment, pegfilgrastim (and biosimilar filgrastim to update advances in the field. Methods: The preferred reporting items for systematic reviews and meta-analyses PRISMA statement were applied, and a random-effect model was used. Primary endpoints were the rate and duration of grade 3 or 4 neutropenia, and an incidence rate of febrile neutropenia. Secondary endpoints were time to absolute neutrophil count ANC recovery, depth of ANC nadir (lowest ANC), neutropenia-related hospitalization and other neutropenia-related complications. For filgrastim versus biosimilar filgrastim comparison, the primary efficacy endpoint was the mean difference in duration of severe neutropenia DSN. Results: A total of 56 studies were considered that included data from 13,058 cancer patients. The risk of febrile neutropenia in filgrastim versus placebo/no treatment was not statistically different. The risk ratio for febrile neutropenia was 0.58, a 42% reduction in favor of filgrastim. The most reported adverse event with FIL was bone pain. For pegfilgrastim versus filgrastim, no statistically significant difference was noted. The risk ratio was 0.90 (95% CI 0.67 to 1.12). The overall difference in duration of severe neutropenia between filgrastim and biosimilar filgrastim was not statistically significant. The risk ratio was 1.03 (95% CI 0.93 to 1.13). Conclusions: Filgrastim was effective and safe in reducing febrile neutropenia and related complications, compared to placebo/no treatment. No notable differences were found between pegfilgrastim and filgrastim in terms of efficacy and safety. However, a similar efficacy profile was observed with FIL and its biosimilars.

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Filgrastim-alone versus pegylated filgrastim-alone for autologous peripheral blood stem cells mobilization in newly diagnosed multiple myeloma patients

Abstract: We can conclude that pegfilgrastim alone is at least equally successful as filgrastim alone for the PBSC mobilization in newly diagnosed myeloma patients.

Cited by 8 publications

References 33 publications

Mobilization of Hematopoietic Progenitor Cells for Autologous Transplantation Using Pegfilgrastim and Plerixafor: Efficacy and Cost Implications

Mobilization of Hematopoietic Progenitor Cells for Autologous Transplantation Using Pegfilgrastim and Plerixafor: Efficacy and Cost Implications

Efficacy of hematopoietic stem cell mobilization regimens in patients with hematological malignancies: a systematic review and network meta-analysis of randomized controlled trials

Efficacy and Safety of Filgrastim and Its Biosimilars to Prevent Febrile Neutropenia in Cancer Patients: A Prospective Study and Meta-Analysis

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