Application of Mecapegfilgrastim for Peripheral Blood Hematopoietic Stem Cell Mobilization in Patients With Hematologic Neoplasms and Analysis of Predictors for Poor Mobilization

  Objective  To evaluate the efficacy of applying mecapegfilgrastim for peripheral blood hematopoietic stem cell (PBSC) mobilization in patients with hematologic neoplasms, and to investigate the influencing factors of PBSC collection.

  Methods  Patients who underwent PBSC mobilization in the Department of Hematology, Mianyang Central Hospital between April 2016 and May 2022 were retrospectively analyzed. The CD34⁺ cell collection results of two groups, the mecapegfilgrastim group (n=28), or the PEG group, and the recombinant human granulocyte colony-stimulating factor (rhG-CSF) group (n=30), were compared, and the influencing factors of collection failure were analyzed.

  Results  The success rates of CD34⁺ cells collection in the PEG group and the rhG-CSF group were 75.0% and 63.3%, respectively (P>0.05). The median CD34⁺ cell counts were 3.37×10⁶/kg and 2.68×10⁶/kg, respectively, showing no significant difference. After combined mobilization with plerixafor, the median counts of CD34⁺ cells collected in the PEG group and rhG-CSF group were 4.23×10⁶/kg and 3.26×10⁶/kg, respectively, showing no significant difference (P>0.05). There was no significant difference in hematopoietic system reconstruction and infections between the two groups (P>0.05). Multivariate analysis found non-plasma cell disease (odds ratio OR=19.697, 95% confidence interval CI: 1.501-258.537, P=0.023), anemia before collection (OR=18.571, 95% CI: 1.354-254.775, P=0.029) and white blood cell count before collection under 32×10⁹ L⁻¹ (OR=85.903, 95% CI: 4.947-1491.807, P=0.002) to be independent risk factors for PBSC collection failure.

  Conclusion  The effect of PBSC mobilization with mecapegfilgrastim was comparable to that of rhG-CSF in patients with hematologic neoplasms. Furthermore, combined mobilization with plerixafor was feasible and effective. Patients with leukemia or lymphoma, anemia, and WBC<32×10⁹ L⁻¹ before stem cell collection have a high probability of PBSC collection failure.