Pegfilgrastim versus filgrastim for chemo-mobilized stem cell collection in multiple myeloma: A retrospective real-world study.

BACKGROUND

Autologous stem cell transplantation (ASCT) is a standard treatment for newly diagnosed multiple myeloma (MM). Achieving sufficient stem cell yield via effective mobilization promotes successful hematological reconstitution. However, clinical evidence regarding the comparative outcomes of pegfilgrastim (PEG) versus filgrastim (FIL) remains controversial, lacking regimen-specific comparisons.

OBJECTIVE

To evaluate the efficacy, safety, efficiency, and costs of PEG versus FIL in MM patients, and compare the impact of cyclophosphamide-based chemo-mobilization on these outcomes.

STUDY

DESIGN

This single-center retrospective study included 102 MM patients (PEG: n = 49; FIL: n = 53). Primary endpoints were CD34⁺ cell yield, mobilization success, duration, and time to engraftment. Statistical analyses included propensity score matching (PSM), overlap weighting (OW), and subgroup analysis.

RESULTS

In the overall cohort, PEG and FIL showed equivalent median CD34⁺ yields (3.90 vs. 4.99 × 10⁶/kg, P = 0.096), mobilization success rates, and total hospitalization costs (P = 0.53). FIL yielded a higher total mononuclear cell count (P < 0.001). Subgroup analysis revealed PEG reduced mobilization duration (10 vs. 15 days, P < 0.001) and sessions in chemo-mobilization. PSM showed comparable yields and engraftment. To address PSM sample attrition and balance covariates, OW was utilized, further confirming that PEG significantly shortened overall duration (P = 0.04) and reduced sessions (P = 0.02). Both regimens exhibited similar engraftment kinetics and safety.

CONCLUSION

Both PEG and FIL demonstrate equivalent efficacy for stem cell mobilization in MM. PEG offers superior efficiency by shortening duration and reducing sessions without increasing the total economic burden.