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Pegylated granulocyte‐colony stimulating factor versus non‐pegylated granulocyte‐colony stimulating factor for peripheral blood stem cell mobilization: A systematic review and meta‐analysis
Author(s) -
Kuan Jew W.,
Su Anselm T.,
Leong Chooi F.
Publication year - 2017
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21550
Subject(s) - medicine , filgrastim , apheresis , granulocyte colony stimulating factor , meta analysis , pegfilgrastim , randomized controlled trial , adverse effect , confidence interval , surgery , chemotherapy , platelet
Abstract Granulocyte‐colony stimulating factor (G‐CSF) mobilizes and increases the amount of hematopoietic stem cells in peripheral blood, enabling its harvest by few apheresis procedures. The pegylated G‐CSF has longer half‐life and is given once only, which is more comfortable for patients, whereas the non‐pegylated requires multiple daily injection because of its short half‐life. We summarized results of randomized trials comparing the efficacy and safety of pegylated and non‐pegylated G‐CSF for peripheral blood stem cell mobilization. We searched the Cochrane CENTRAL, MEDLINE, EMBASE, and two conference proceedings. Two authors made the selection, extracted data and evaluated methodological quality using GRADE independently. We used random‐effects model for meta‐analysis. We found 3956 records and retrieved 47 full texts. We included eight randomized trials with a total number of 554 randomized and 532 analyzed subjects. The meta‐analysis included five trials because not all trials reported the same outcomes. Pooling data from two studies shows no evidence for a difference in the successful mobilization rate (CD34+ cell ≥ 2 × 10 6 /kg collected) between pegfilgrastim 6 mg (early administration) and filgrastim 5 µg/kg/day (147 participants; risk ratio (RR) 0.87, 95% confidence interval (95%CI) 0.67‐1.11; P = .26). Pooling data from three studies shows no difference in the incidence of adverse events between pegylated and non‐pegylated G‐CSF (170 participants; RR 0.86, 95%CI 0.34‐2.17; P = .75). No difference found on the quantity of CD34+ cells collected, number of apheresis procedure in successful mobilization, level of peak PB CD34+ cells achieved, and day of neutrophil and platelet engraftment.