Pegfilgrastim compared with filgrastim after high‐dose melphalan and autologous hematopoietic peripheral blood stem cell transplantation in multiple myeloma patients

  We undertook a comparative study of Pegfilgrastim vs. Filgrastim after high‐dose melphalan and autologous peripheral blood stem cell transplantation (APBSCT) in multiple myeloma (MM) patients. Thirty‐seven consecutive patients were randomly assigned to receive a single 6 mg dose of Pegfilgrastim on day 1 post‐transplant ( n  = 18 patients) vs. daily subcutaneous injections of Filgrastim 5  μ g/kg ( n  = 19 patients) starting on day 5 post‐transplant. The median duration of grade 4 neutropenia in the Pegfilgrastim and Filgrastim groups was 5 and 6 d, respectively ( P  = ns). The results for the two groups were also not significantly different for time to neutrophil and platelet recovery, but incidence of febrile neutropenia (61.1% vs. 100%, P  = 0.003) and duration of febrile neutropenia (1.5 d vs. 4 d, P  = 0.005), were lower in the Pegfilgrastim arm. After initial haematopoietic reconstitution, we observed significantly higher value of leukocytes × 10 9  L on day 15 (6.0 vs. 2.7, P  = 0.004), in the Pegfilgrastim group compared with the Filgrastim group. This study shows that a single injection Pegfilgrastim can be used with safety and efficacy similar to those provided by daily injections of Filgrastim and it is associated with a decrease incidence of infectious events after APBSCT in MM patients.