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[Efficacy and Safety of Mecapegfilgrastim versus rhG-CSF for Peripheral Blood Stem Cell Mobilization in Healthy
Liu Tang1, Yan Chen1, Xiu-Qin Zuo1
1Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
Objective:
To compare the efficacy, safety, and pharmacoeconomic differences between Mecapeg-filgrastim and recombinant human granulocyte colony-stimulating factor （rhG-CSF） in mobilizing peripheral blood stem cells （PBSCs） from healthy donors.
Methods:
A total of 100 healthy donors who underwent PBSC mobilization at our center between January 2022 and June 2025 were included and assigned to the Mecapegfilgrastim group or the rhG-CSF group. Successful mobilization was defined as CD34+cells ≥2×106/kg, and optimal mobilization as ≥5×106/kg. The mobilization efficacy, adverse events, and medical costs between the two groups were compared. Outcomes of the corresponding recipients were evaluated, including the dose of infused cells, the time to hematopoietic recovery, and the incidence of acute graft-versus-host disease（aGVHD）.
Results:
The mobilization success rate was 100% in both groups. The optimal mobilization rate （98.0% vs. 80.0%, P=0.004） and median number of mobilized CD34+ cells ［7.84（4.86-20.86） vs. 5.85（2.99-15.20）×106/kg, P<0.001］ in the mecapeg-filgrastim group were significantly higher than that in the rhG-CSF group, while the number of mononuclear cells was lower ［10.13（5.38-24.80） vs. 12.16（4.99-28.38） × 108/kg, P=0.049］. The engraftment rates of the two groups of recipients （88% vs. 90%） and aGVHD incidence rates （52.3% vs. 48.9%） showed no significant differences（P>0.05）. However, compared with the rhG-CSF group, the Mecapegfilgrastim group showed significantly shorter neutrophil （14 vs. 16 days） and platelet （13 vs. 22 days） engraftment time （both P<0.001）. The incidence and spectrum of adverse events were comparable between the two groups, with no statistically significant difference（32.0% vs.30.0%, P>0.05）. Additionally, compared with the rhG-CSF group, the Mecapegfilgrastim group had a shorter donor hospitalization length ［2（2-3） vs. 6（6-7）days］ and lower mobilization costs（both P<0.001）.
Conclusion:
In healthy donor PBSC mobilization, Mecapegfilgrastim is non-inferior to rhG-CSF, offers superior promotion of hematopoietic recovery in recipients, and provides significant advantages in reducing hospital stay and medical costs with a comparable safety profile. Mecapegfilgrastim thus represents a more cost-effective mobilization strategy.
