Pegfilgrastim‐ versus filgrastim‐based autologous hematopoietic stem cell mobilization in the setting of preemptive use of plerixafor: efficacy and cost analysis

Abstract

Single administration of 12 mg of PEG is associated with better CD34+ mobilization than FIL allowing for effective, convenient mobilization with less frequent use of plerixafor.

Plerixafor plus pegfilgrastim is a safe, effective mobilization regimen for poor or adequate mobilizers of hematopoietic stem and progenitor cells: a phase I clinical trial

“…Recent data also suggest that when pegfilgrastim 12 mg stat dose, rather than filgrastim 10 mcg/kg/ day is used for steady-state mobilization in a risk-adapted plerixafor protocol, pegfilgrastim-mobilized patients were less likely to require the addition of plerixafor to meet mobilization targets. 27 Our data would suggest that the cost of mobilization in this protocol could be further reduced by the use of 6 mg pegfilgrastim.…”

Growth factor plus preemptive (‘just-in-time’) plerixafor successfully mobilizes hematopoietic stem cells in multiple myeloma patients despite prior lenalidomide exposure

“…The development and validation of this algorithm has been described elsewhere, 22,24 as well as the performance of this algorithm in the setting of pegfilgrastim-based mobilization. 23 Steady state filgrastim-based and pegfilgrastim-based mobilization were performed in two consecutive cohorts and the choice of growth factor was not influenced by any patient or disease characteristic.…”

“…20,21 In this study, we examine 89 patients with MM (49 previously exposed to lenalidomide) who proceeded to steady state growth factor-based AHSC mobilization with preemptive ('just in time') use of plerixafor depending on peripheral blood CD34 þ enumeration on the 4th day of mobilization and following a previously validated and published algorithm. 14,22,23 The goals of the study are to determine if growth factor plus preemptive plerixafor overcomes the negative effect of lenalidomide on AHSC mobilization, and to estimate the impact of prior lenalidomide on plerixafor use, mobilization cost and resource utilization.…”

Peripheral Blood Progenitor Cells Mobilization in Patients with Multiple Myeloma

“…Plasma G-CSF levels were about 1 log higher with pegfilgrastim, but in the setting of autologous ASCT, this did not result into a faster hematopoietic recovery. Only few data are available on the biological effects of pegfilgrastim, which suggest that pegfilgrastim stimulation results in different functional properties of hematopoietic stem and progenitor cells compared with conventional G-CSF [74,75].…”