Pegfilgrastim (Neulasta) for Stem Cell Mobilization in Patients With Multiple Myeloma
Status:
Completed
Trial end date:
2007-04-01
Target enrollment:
Participant gender:
Summary
In recent years PBPC have replaced bone marrow as the source of hematopoietic stem cells for
autologous transplantation. One of the cited advantages of this procedure is the avoidance of
bone marrow harvest, which frequently requires general anesthesia. Other advantages include
faster neutrophil and platelet engraftment times, faster immune recovery, decrease in the
amount of tumor contamination and technical ability to obtain stem cells from patients
previously considered unharvestable because of marrow fibrosis or because of prior
radiotherapy to the pelvis. Filgrastim has emerged as the preferred cytokine for stem cell
mobilization based on its safety profile and the positive experience in granulocyte donors
however, the number of circulating CD34+ cells does not occur until the third day after
starting filgrastim injections. Pegfilgrastim stimulates the production and maturation of
neutrophil precursors and enhances the functions of mature neutrophils in the same manner as
filgrastim. Data form normal volunteers and in studies of patients with cancer have shown
prolonged serum levels of the cytokine, with "self-regulation" of pegfilgrastim levels as a
function of the neutrophil count. This confers a therapeutic advantage in clinical settings
by allowing a less frequent dosing.