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.