Comparison Of The Role Of PEG-G-CSF And G-CSF In Autologous Transplantation Of Peripheral Blood Stem Cells Mobilization

Objective: To evaluate the efficacy and safety of PEG-G-CSF and GCSF mobilization in autologous transplantation of peripheral blood hematopoietic stem cells,we conducted a review and meta-analysis of PEG-GCSF and G-CSF mobilization in peripheral blood.Methods: The Cochrane Library,Pub Med,Embase,CNKI,Wanfang and other databases were searched in electronic literature,and all relevant literatures on PEG-G-CSF and G-CSF combined chemotherapy in autologous transplantation peripheral blood stem cell mobilization were collected.After referring to the inclusion and exclusion criteria,all the literatures were screened by two researchers.After quality assessment and data extraction,Rev Man5.3 software was used to conduct Metaanalysis on the data extracted from the literatures.Results: 13 studies(10retrospective studies,2 randomized controlled trials,and 1 non-randomized controlled trial)involving 1227 patients were included.Meta-analysis showed that PEG-G-CSF mobilization increased CD34+ cell collection yield in terms of primary outcome measures [SMD=-0.23,95%CI(-0.42 ～-0.05),P=0.01],there was no significant difference in the success rate of autologous peripheral blood stem cell mobilization between PEG-G-CSF and G-CSF [RR=0.96,95%CI(0.92～ 1.01),P>0.05].In terms of secondary outcome indicators,PEG-G-CSF showed significantly faster blood collection start time [SMD=-0.71,95%CI(-1.16 ～-0.25),P=0.002),after the mobilization of stem cell collection times did not see obvious difference [SMD=0.51,95%CI(1.56 ～ 0.54),P=0.35),the incidence of adverse reactions after the mobilization effect [RR=1.05,95%CI(0.90 ～ 1.23),P=0.54).No significant difference was observed in the time of leukocyte and platelet implantation after transplantation(P>0.05).Conclusions:1.For multiple myeloma and lymphoma patients receiving autologous HSCT,the chemotherapy combined with PEG-G-CSF mobilization group significantly increased the first collection time after mobilization,and the total number of collected CD34+ cells was higher than that of the G-CSF group;2.Chemotherapy combined with PEG-G-CSF and G-CSF groups had similar effects in mobilization success rate,collection times after mobilization,incidence of adverse reactions,and recovery time of white blood cells and platelets.3.PEG-G-CSF may be a convenient alternative for chemokine mobilization in patients with multiple myeloma and lymphoma.