title: Long-active granulocyte colony-stimulating factor for peripheral blood hematopoietic progenitor cell mobilization.
abstract: BACKGROUND
  Peg-filgrastim (PEG-FIL), a polyethylene glycol-conjugated form of granulocyte colony-stimulating factor (G-CSF), has been introduced in clinical practice and is effective in shortening the time of neutropenia after cytotoxic chemotherapy. G-CSF has emerged as the preferred cytokine for hematopoietic progenitor cells' (HPC) mobilization. Nevertheless, data on the ability of PEG-FIL in this field have been published.
  
  
  METHODS
  We review publications in the field with the goal of providing an overview of this approach.
  
  
  CONCLUSIONS
  PEG-FIL may be able to mobilize CD34(+) cells in a more timely fashion than G-CSF, with the advantages of only a single-dose administration, an earlier start and a reduction in the number of apheresis procedures. The main controversies concern the dosage of the drug and the optimal dose. In the context of chemo-mobilization, a single dose of 6 mg PEG-FIL seems effective in terms of HPC's mobilization and there is no increase in this effect if the dose is doubled to 12 mg. Steady-state mobilization requires higher doses of PEG-FIL and this approach is not cost-effective when compared with G-CSF. The experiences with PEG-FIL in the healthy donor setting are very limited.
authors.affiliation: Department of Oncology and Hematology, Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera BMM , Via Cantaffio, 89133 Reggio Calabria , Italy dr.massimomartino@gmail.com.
authors.forename: Massimo
authors.initials: M
authors.lastname: Martino
authors.forename: Daniele
authors.initials: D
authors.lastname: Laszlo
authors.forename: Francesco
authors.initials: F
authors.lastname: Lanza
mesh_terms: D000818:Animals; D018952:Antigens, CD34 / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002465:Cell Movement / Q000187:drug effects*; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim
keywords: Peg-filgrastim; growth factors; healthy donors; hematopoietic progenitor cells mobilization; lymphoma; multiple myeloma; transplant