A randomised study comparing peripheral blood progenitor mobilisation using intermediate-dose cyclophosphamide plus...

Area of Science:

• Hematology
• Stem Cell Transplantation
• Oncology

Background:

• Hematopoietic stem cell transplantation (HSCT) relies on effective progenitor cell mobilization.
• Current mobilization strategies involve growth factors and chemotherapy, each with associated toxicities.

Purpose of the Study:

• To compare the efficacy and safety of lenograstim (G-CSF) alone versus cyclophosphamide plus lenograstim for outpatient progenitor cell mobilization.
• To evaluate differences in mobilization efficiency, patient morbidity, hospitalization duration, apheresis requirements, and engraftment kinetics.

Main Methods:

• Prospective randomized study comparing two mobilization regimens: lenograstim alone (10 µg/kg) versus intermediate-dose cyclophosphamide (2 g/m²) plus lenograstim (5 µg/kg).
• Outpatient progenitor cell mobilization was assessed.
• Key endpoints included mobilization success rate, median CD34+ cell yield, apheresis procedures, hospital stay, and engraftment times.

Main Results:

• Successful mobilization rates were 70% for G-CSF alone and 56.4% for cyclophosphamide-G-CSF (P=0.21).
• Median CD34+ cell yields were comparable (2.3 x 10⁶/kg vs. 2.2 x 10⁶/kg).
• The cyclophosphamide-G-CSF group experienced significantly higher rates of nausea, vomiting, and longer hospitalizations (P<0.05).

Conclusions:

• Lenograstim (G-CSF) at 10 µg/kg is a viable alternative to cyclophosphamide plus G-CSF for progenitor cell mobilization.
• G-CSF alone offers reduced toxicity and shorter hospital stays compared to the combination regimen.
• This approach is preferable when aggressive cytoreduction is not necessary for disease control.