Effectiveness and Safety of Autologous Stem Cell Mobilization with Granulocyte Colony Stimulating Factor in an Inpatient or Outpatient Setting

Abstract

Aim:Autologous hematopoietic stem cell transplantation is the most frequently used treatment method in the treatment of lymphoma and myeloma patients. To apply this treatment method, first of all, a sufficient number of stem cells must be collected from the patient. With the development of apheresis methods and safe, effective mobilization methods, it is now possible to collect stem cells in an outpatient manner. In our study, we aimed to compare the efficacy and safety of outpatient based mobilization versus inpatient based mobilization of hematopoietic stem cells with granulocyte-colony stimulating factor (G-CSF) alone in patients with myeloma and lymphoma.Materials and Methods:A total of 89 patients, including 54 patients who underwent outpatient and 35 patients who underwent inpatient based mobilization of stem cells with G-CSF alone were included in the study. Outpatient and inpatient based mobilization groups were compared in terms of efficacy and safety. Statistical analyses were performed with Jamovi 1.2.27 software. The Mann-Whitney U and chi-square tests were used to examine the differences. MANCOVA was used for univariate and multivariate statistical analysis of factors influencing mobilization.Results:Three leukaphereses resulted in the collection of a mean 9.73x106/kg (4.5-16.5) CD34+ cells in the outpatient based mobilization group and a mean 11.8x106/kg (3.56-59) CD34+ cells in the inpatient based mobilization group (p=0.14). Life-threatening side effects were not observed in any of the patients. Grade 1, 2 side effects were observed and there was no significant statistical difference between the two groups.Conclusion:In this study, we found no significant difference in terms of efficacy and safety between the outpatient and the inpatient based mobilization group patients with myeloma and lymphoma who were mobilized with G-CSF. The results of our study show that outpatient based mobilization can be effectively and safely performed with g-csf, especially in patients who need autologous transplantation and avoid hospitalization, as in the current Coronavirus disease-2019 pandemic.

Keywords

• mobilization
• granulocyte-colony stimulating factor
• g-csf
• filgrastim
• autologous hematopoietic stem cell mobilization
• apheresis
• leukapheresis