title: The comparison of Filgrastim (Neupogen®), biosimilar filgrastim (Leucostim®) and Lenograstim (Granocyte®) as a first line peripheral blood stem cell mobilization strategy in autologous hematopoieitic stem cell transplantation: a single center experience from Turkey.
abstract: OBJECTIVE
  Patients affected by hematological malignancies can often benefit from high dose chemotherapy followed by peripheral blood stem cells (PBSCs) transplantation. Different strategies have been used to mobilize an adequate number of PBSC, including granulocyte colony-stimulating factor (G-CSF) alone or chemotherapy plus G-CSF. In this study, we aimed to compare the efficacy profile of different G-CSF agents including filgrastim (Neupogen®), biosimilar filgrastim (Leucostim®) and Lenograstim (Granocyte®) on CD34(+) mobilization in patients who underwent autologous hematopoietic stem cell transplantation (autoHSCT).
  
  
  METHODS
  We retrospectively analysed data of patients who underwent autoHSCT diagnosed with multiple myeloma (MM), Hodgkin Lymphoma (HL), non-Hodgkin Lymphoma (NHL) and others. Data for stem cell mobilization has been obtained from patients' files. Patients who received Filgrastim (Neupogen®), biosimilar Filgrastim (Leucostim®, Group) and Lenograstim (Granocyte®) were evaluated mainly for total CD34(+) cell count at the end of mobilization procedure.
  
  
  RESULTS
  A total of 96 patients who underwent autoHSCT were retrospectively analyzed. 27 (28.2%) of the patients were female, and 69 (71.8%) were male. The diagnosis of the patients were; multiple myeloma (39 patients, 40.6%), Hodgkin Lyphoma (23 patients, 23.9%), non-Hodgkin lymphoma (16 patients, 16.6%), and others (18 patients, 18.9%). The median number of leukapheresis cycle necessary to harvest a minimal count of 3×10(6) CD34(+)/kg was 2 in Neupogen® (min-max: 1-4) and Granocyte® (min-max: 1-3) groups and 1 (min-max: 1-2) in Leucostim® group. The median doses of G-CSF agents (μg/kg/day) in PBSC collection procedure were; 10.00 (min-max: 7.00-12.00) in the Neupogen® group, 8.00 (min-max: 7.25-9.00) in the Leucostim® group and 8.50 (6.00-9.50) in the Granocyte® group. There was no statistical significance among groups (p=0.067). The number of total collected PB CD34(+) cells (×10(6)/kg) was 7.64 (min-max: 4.09-13.86) in the Neupogen® group, 13.43 (min-max: 8.15-23.38) in the Leucostim® group and 5.45 (min-max: 4.28-9.40) in the Granocyte® group. The data showed that patients in the leucostim group had significantly higher PB CD34(+) cells compared to patients in the Granocyte® group (p=0.013).
  
  
  CONCLUSIONS
  Leucostim® was comparable to Neupogen® for PBSC mobilization in patients who underwent autoHSCT.
authors.affiliation: Dedeman Stem Cell Transplantation Hospital, Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey. drssivgin@gmail.com
authors.forename: Serdar
authors.initials: S
authors.lastname: Sivgin
authors.forename: Esen
authors.initials: E
authors.lastname: Karakus
authors.forename: Leylagul
authors.initials: L
authors.lastname: Kaynar
authors.forename: Fatih
authors.initials: F
authors.lastname: Kurnaz
authors.forename: Cigdem
authors.initials: C
authors.lastname: Pala
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Keklik
authors.forename: Gokmen
authors.initials: G
authors.lastname: Zararsiz
authors.forename: Musa
authors.initials: M
authors.lastname: Solmaz
authors.forename: Bulent
authors.initials: B
authors.lastname: Eser
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Ali
authors.initials: A
authors.lastname: Unal
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006098:Granulocytes / Q000166:cytology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D014421:Turkey
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim