title: Pegfilgrastim vs filgrastim in PBSC mobilization for autologous hematopoietic SCT: a systematic review and meta-analysis.
abstract: Trial outcomes comparing cytokine agents for PBSC mobilization in autologous hematopoietic transplant patients have been controversial. We performed a systematic review and meta-analysis of evidence available on pegfilgrastim vs filgrastim in chemo-cytokine mobilization. Electronic literature searches of PubMed, EMBASE and CENTRAL identified nine articles eligible for qualitative analysis with one randomized controlled trial. Eight articles involving 719 patients were included in the meta-analysis. Results showed similar CD34+ cell collection yields for pegfilgrastim and filgrastim (SDM -0.08, 95% CI: -0.388 to 0.228). On comparison with filgrastim, pegfilgrastim showed a significantly earlier apheresis onset time (SDM: -0.512, 95% CI: -0.973 to -0.050) and reduction in required apheresis procedures (SDM -0.260, 95% CI: -0.466 to -0.054). Times to leukocyte (⩾1.0 × 10(9)/L) and platelet (⩾20 × 10(9)/L) recovery were similar between groups (SDM: 0.015, 95% CI: -0.41 to 0.44 and SDM: 0.309, 95% CI: -0.11 to 0.72, respectively). Both agents were well tolerated and mild bone pain was the most frequently reported adverse event. Pegfilgrastim may be a convenient alternative to filgrastim in PBSC mobilization for multiple myeloma and lymphoma patients, but further studies are required to clarify effects of cytokine dosage and previous cytotoxic exposure in specific subpopulations.
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Gwanak-gu, Seoul, Korea.
authors.forename: M G
authors.initials: MG
authors.lastname: Kim
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Gwanak-gu, Seoul, Korea.
authors.forename: N
authors.initials: N
authors.lastname: Han
authors.affiliation: School of Pharmacy, Sungkyunkwan University, Suwon-si, Gyeonggi-do, Korea.
authors.forename: E-K
authors.initials: EK
authors.lastname: Lee
authors.affiliation: College of Pharmacy, Chonnam National University, Buk-gu, Gwangju, South Korea.
authors.forename: T
authors.initials: T
authors.lastname: Kim
mesh_terms: D005260:Female; D000069585:Filgrastim / Q000627:therapeutic use*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006401:Hematologic Agents / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006412:Hematopoietic Stem Cells; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D006401:Hematologic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim