Comparative efficacy and safety of etoposide plus PEG-rhG-CSF versus etoposide plus G-CSF for haematopoietic stem cell mobilisation in patients with multiple myeloma and lymphoma.

INTRODUCTION: Efficient and safe mobilisation of haematopoietic stem cells is essential for successful autologous haematopoietic stem cell transplantation (ASCT). Although pegylated recombinant human granulocyte colony stimulating factor, (PEG-rhG-CSF) is widely used for chemotherapy-induced neutropenia, comparative data on its use with high-dose etoposide (VP-16) for mobilisation remain scarce. In particular, direct comparisons between mecapegfilgrastim and recombinant human G-CSF (rhG-CSF) in this setting are lacking.

METHODS: In this retrospective study, we analysed the efficacy and safety of high-dose VP-16 (1.6 g/m2) combined with PEG-rhG-CSF (100 μg/kg) versus high-dose VP-16 (1.6 g/m2) combined with rhG-CSF (10 μg/kg/d) for stem cell mobilisation.

RESULTS: Seventy-one patients were included: 32 received VP-16+PEG-rhG-CSF and 39 received VP-16+rhG-CSF. Baseline characteristics were comparable. Mobilisation success exceeded 90% in both groups. However, the PEG-rhG-CSF group achieved a significantly higher total CD34+ cell yield, a greater proportion of optimal mobilisers, and a higher first-day collection success rate. Fewer number of apheresis and a shorter mobilisation duration were observed in this group. The incidence of febrile infection was significantly lower with PEG-rhG-CSF, whereas platelet transfusion requirements and engraftment kinetics were similar between groups.

CONCLUSIONS: High-dose VP-16 combined with PEG-rhG-CSF demonstrated superior efficacy, safety, and procedural efficiency compared with high-dose VP-16 plus rhG-CSF. These findings suggest that this regimen represents a promising and potentially preferable alternative for haematopoietic stem cell mobilisation in patients with multiple myeloma or lymphoma.