Abstract

INTRODUCTION

A sufficient dose of CD34+ stem cell mobilization is a prerequisite for successful autologous hematopoietic stem cell transplantation. We aimed to compare the original filgrastim (Neupogen) with the biosimilar filgrastim (Tevagrastimin) in terms of efficacy in peripheral blood stem cell mobilization.

METHODS

Ninety-five patients who underwent stem cell mobilization, were analyzed retrospectively. We used Cyclophosphamide (low dose: 2g / m2 or high dose: 3-4 g / m2), as a mobilization regimen, on the first day and G-CSF at a dose of 5 g / kg was started one day after chemotherapy.

RESULTS

Stem cell mobilization was performed with Neupogen in 50 patients and with Tevagrastim in 45 patients. While there was no statistically significant difference between the demographic characteristics of the patients out of cyclophosphamide dose. Higher dose cyclophosphamide was used more in the arm receiving Neupogen (p <0.05). No statistically significant difference was found between the use of original and biosimilar products in terms of achieving the target of 2 x 106 / kg, which is the minimum CD34+ cell dose required for adequate engraftment, and 4 x 106 / kg for double transplantation (p> 0.05). However, if the target level of CD34+ stem cell was above 6 x 106 / kg, a statistically significant difference was observed in favor of Neupogen arm (p = 0.021). Neutrophil engraftment was shorter in the Neupogen arm compared to the Tevagrastim arm (p = 0.015).

DISCUSSION AND CONCLUSION

The difference was observed in favor of the Neupogen arm, when stem cell collection was aimed at above 6 x 106 / kg. The reason for this difference was thought to be related to the higher dose of cyclophosphamide used in the original molecule arm. We need further studies that were included more cases which are used high-dose cyclophosphamide for comparing the biosimilar molecule with the original molecule.