Mobilization of hematopoietic stem cells with lenograstim in multiple myeloma patients: prospective multicenter observational study (KMM122)

Current guidelines recommend using filgrastim or tbo-filgrastim to mobilize hematopoietic progenitor cells in an autologous setting. However, previous studies have suggested other forms of granulocyte colony-stimulating factor (G-CSF) are equally efficacious, possibly with fewer leukaphereses required. Thus, we prospectively studied the efficacy of lenograstim, a glycosylated recombinant form of G-CSF, in multiple myeloma (MM). From November 2011 to January 2020, 98 MM patients undergoing autologous stem cell transplant (ASCT) from 5 academic centers in Korea were enrolled. Donors were mobilized with subcutaneous lenograstim (Neutrogin®) with fixed doses of 10 ug/kg for four days. Most of patients (N = 90, 91.8%) achieved at least the targets of 2 x 106 CD34+ cells/kg and more than half of patients (N = 57, 58.2%) reached target of 5 x 106 CD34+ cells/kg. The mobilization failure rate was 8.2% (N = 8). The median number of CD34+cell/kg using G-CSF only was 5.25 x 106/kg (range 0.49-13.47). There were no grade 3 or 4 adverse events during mobilization. BSA at mobilization and platelet transfusion were factor associated with CD34+ collection. Most patients achieved neutrophil (N = 93, 98.9%) and (N = 89, 94.7%) engraftment. Lenograstim can safely and effectively mobilize stem cells in MM autologous settings.