The effects of single-dose biosimilar filgrastim (leucostim®), filgrastim (neupogen®) and lenograstim (granocyte®) on bone marrow-derived stem cell collection for allogeneic stem cell transplantation: A single center experience and systematic review

Abstract

Introduction: Bone marrow (BM) has been used as the source of stem cells for allogeneic hematopoietic stem cell transplant. However, peripheral blood stem cells (PBSC) for allogeneic HSCT have gained more popularity after the recent use of granulocyte colony-stimulating factor (G-CSF) for mobilization. Adult studies of the BM product mobilized using G-CSF (G-BM) have shown faster white blood cell engraftment, similar to that produced by PBSC, however, with less acute and chronic graft versus host disease disease. Methods: In order to increase the CD34 cell content of the bone marrow product, three different G-CSFs were used: biosimilar filgrastim (Leucostim®) (n=29), original filgrastim (Neupogen®) (n=30), and lenograstim (Granocyte®) (n=30). These G-CSFs were compared with one another and with the control group (n=30). The data obtained with the products collected from the BM of healthy donors in the control group and those who received G-CSF were analyzed. All donors were administered G-CSF 10 µg/kg daily at least 24 hours before BM harvesting. Results: In terms of the amount of CD34/UL per microliter BM harvesting, the group receiving Lenograstim (Granocyte®) was found to have a statistically significant higher CD34/UL value compared to the other groups. There was no statistically significant difference between the median CD34/UL values across the control, filgrastim and biosimilar-filgrastim groups. Biosimilar filgrastim (Leucostim®), original filgrastim (Neupogen®) and lenograstim (Granocyte®) can be safely used for BM CD34 cell mobilization in donors of patients undergoing allo-HSCT. Conclusion: Considering the amount of CD34/UL collected in the product, Lenograstim (Granocyte®) should be more preferable.