A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization
There are few randomized trials comparing filgrastim and pegfilgrastim in peripheral blood stem cell mobilization (PBSCM). None of the trials studied the effects of the timing of pegfilgrastim administration on the outcomes of mobilization. We conducted a randomized triple blind control trial compar...
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my.unimas.ir.361512023-07-31T02:59:56Z http://ir.unimas.my/id/eprint/36151/ A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization Kuan, Jew Win Anselm, Su Ting SP, Wong XY, Sim SG, Toh TC, Ong JS, Rajasuriar SH, Lim YK, Guan HK, Liew PK, Liew JT, Tan AN, Kori YY, Cheng SM, Tan KM, Chang RZ Other systems of medicine There are few randomized trials comparing filgrastim and pegfilgrastim in peripheral blood stem cell mobilization (PBSCM). None of the trials studied the effects of the timing of pegfilgrastim administration on the outcomes of mobilization. We conducted a randomized triple blind control trial comparing the outcomes of filgrastim 5 microg/kg daily from day 3 onwards, 'early' pegfilgrastim 6 mg on day 3 and 'delayed' pegfilgrastim 6 mg on day 7 in cyclophosphamide PBSCM in patients with no previous history of mobilization. Peripheral blood (PB) CD34+ cell count was checked on day 8 and day 11 onward. Apheresis was started when PB CD34+ >/= 10/microl from day 11 onward. The primary outcome was the successful mobilization rate, defined as cumulative collection of >/=2 x 10(6)/kg CD34+ cells in three or less apheresis. The secondary outcomes were the day of neutrophil and platelet engraftment post transplantation. There were 156 patients randomized and 134 patients' data analyzed. Pegfilgrastim 6 mg day 7 produced highest percentage of successful mobilization, 34 out of 48 (70.8%) analyzed patients, followed by daily filgrastim, 28 out of 44 (63.6%) and day 3 pegfilgrastim, 20 out of 42 (47.6%) (p = 0.075). Pegfilgrastim day 7 and daily filgrastim reported 1.48 (p = 0.014) and 1.49 (p = 0.013) times higher successful mobilization rate respectively as compared to pegfilgrastim day 3 after adjusting for disease, gender and exposure to myelotoxic agent. Multiple myeloma patients were three times more likely to achieve successful mobilization as compared to acute leukemia or lymphoma patients. Pegfilgrastim avoided the overshoot of white cells compared to filgrastim. There was no difference in the duration of both white cells and platelet recovery post transplantation between the three interventional arms. Elsevier 2015-03-30 Article PeerReviewed text en http://ir.unimas.my/id/eprint/36151/1/filgrastim1.pdf Kuan, Jew Win and Anselm, Su Ting and SP, Wong and XY, Sim and SG, Toh and TC, Ong and JS, Rajasuriar and SH, Lim and YK, Guan and HK, Liew and PK, Liew and JT, Tan and AN, Kori and YY, Cheng and SM, Tan and KM, Chang (2015) A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization. Transfusion and Apheresis Science, 53 (2). pp. 196-204. ISSN 1473-0502 https://www.trasci.com/article/S1473-0502(15)00061-0/fulltext http://dx.doi.org/10.1016/j.transci.2015.03.017 |
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RZ Other systems of medicine Kuan, Jew Win Anselm, Su Ting SP, Wong XY, Sim SG, Toh TC, Ong JS, Rajasuriar SH, Lim YK, Guan HK, Liew PK, Liew JT, Tan AN, Kori YY, Cheng SM, Tan KM, Chang A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
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There are few randomized trials comparing filgrastim and pegfilgrastim in peripheral blood stem cell mobilization (PBSCM). None of the trials studied the effects of the timing of pegfilgrastim administration on the outcomes of mobilization. We conducted a randomized triple blind control trial comparing the outcomes of filgrastim 5 microg/kg daily from day 3 onwards, 'early' pegfilgrastim 6 mg on day 3 and 'delayed' pegfilgrastim 6 mg on day 7 in cyclophosphamide PBSCM in patients with no previous history of mobilization. Peripheral blood (PB) CD34+ cell count was checked on day 8 and day 11 onward. Apheresis was started when PB CD34+ >/= 10/microl from day 11 onward. The primary outcome was the successful mobilization rate, defined as cumulative collection of >/=2 x 10(6)/kg CD34+ cells in three or less apheresis. The secondary outcomes were the day of neutrophil and platelet engraftment post transplantation. There were 156 patients randomized and 134 patients' data analyzed. Pegfilgrastim 6 mg day 7 produced highest percentage of successful mobilization, 34 out of 48 (70.8%) analyzed patients, followed by daily filgrastim, 28 out of 44 (63.6%) and day 3 pegfilgrastim, 20 out of 42 (47.6%) (p = 0.075). Pegfilgrastim day 7 and daily filgrastim reported 1.48 (p = 0.014) and 1.49 (p = 0.013) times higher successful mobilization rate respectively as compared to pegfilgrastim day 3 after adjusting for disease, gender and exposure to myelotoxic agent. Multiple myeloma patients were three times more likely to achieve successful mobilization as compared to acute leukemia or lymphoma patients. Pegfilgrastim avoided the overshoot of white cells compared to filgrastim. There was no difference in the duration of both white cells and platelet recovery post transplantation between the three interventional arms. |
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author |
Kuan, Jew Win Anselm, Su Ting SP, Wong XY, Sim SG, Toh TC, Ong JS, Rajasuriar SH, Lim YK, Guan HK, Liew PK, Liew JT, Tan AN, Kori YY, Cheng SM, Tan KM, Chang |
author_facet |
Kuan, Jew Win Anselm, Su Ting SP, Wong XY, Sim SG, Toh TC, Ong JS, Rajasuriar SH, Lim YK, Guan HK, Liew PK, Liew JT, Tan AN, Kori YY, Cheng SM, Tan KM, Chang |
author_sort |
Kuan, Jew Win |
title |
A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
title_short |
A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
title_full |
A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
title_fullStr |
A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
title_full_unstemmed |
A randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
title_sort |
randomized double blind control trial comparing filgrastim and pegfilgrastim in cyclophosphamide peripheral blood hematopoietic stem cell mobilization |
publisher |
Elsevier |
publishDate |
2015 |
url |
http://ir.unimas.my/id/eprint/36151/1/filgrastim1.pdf http://ir.unimas.my/id/eprint/36151/ https://www.trasci.com/article/S1473-0502(15)00061-0/fulltext http://dx.doi.org/10.1016/j.transci.2015.03.017 |
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1773547902198611968 |
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13.19449 |