Feasibility and efficacy of low-dose pegfilgrastim for CD34 ⁺ cell mobilization in lymphoma

Background: Pegfilgrastim has equivalent efficacy to daily granulocyte colony-stimulating factor (G-CSF) in enhancing neutrophil recovery after chemotherapy, but data on its use for peripheral blood stem cell (PBSC) mobilization are limited. We evaluated the safety and efficacy of CD34⁺ PBSC mobilization by low-dose (3.6 mg) pegfilgrastim after chemotherapy in patients with malignant lymphoma.

Study design and methods: Twenty patients with malignant lymphoma were enrolled in this study. Cytotoxic chemotherapy was started on day 1, and 3.6 mg of pegfilgrastim was subcutaneously administered on day 7. CD34⁺ cells were counted in the peripheral blood daily from days 11 to 14 using a flow cytometric analysis.

Results: In 19 of the 20 patients (95%), the CD34⁺ cell counts in the peripheral blood exceeded 10 × 10⁶/L, with a mean value of 20.3 on day 11, 38.0 on day 12, 40.3 on day 13, and 40.1 on day 14. Older age was associated with lower maximum CD34⁺ cell mobilization. The most frequent adverse events associated with pegfilgrastim were back pain, nausea, appetite loss, and lactate dehydrogenase elevation.

Conclusion: Our data indicated that a single dose of 3.6 mg pegfilgrastim on day 7 after chemotherapy safely and effectively mobilized CD34⁺ cells.

Keywords: CD34; mobilization; pegfilgrastim.