G-CSF + plerixafor versus G-CSF alone mobilized hematopoietic stem cells in patients with multiple myeloma and lymphoma: a systematic review and meta-analysis

Abstract

Aim

The combination of granulocyte-colony stimulating factor (G-CSF) and plerixafor is one of the approaches for hematopoietic stem cell mobilization in patients with multiple myeloma (MM), non-Hodgkin’s lymphoma (NHL), and Hodgkin’s lymphoma (HL). This systematic review and meta-analysis aimed to determine the ability of G-CSF + plerixafor to mobilize peripheral blood (PB) CD34+ cells and examine its safety profile.

Methods

We performed a database search using the terms ‘granulocyte colony stimulating factor’, ‘G-CSF’, ‘AMD3100’, and ‘plerixafor’, published up to May 1, 2023. The methodology is described in further detail in the PROSPERO database (CRD42023425760).

Results

Twenty-three studies were included in this systematic review and meta-analysis. G-CSF + plerixafor resulted in more patients achieving the predetermined apheresis yield of CD34+ cells than G-CSF alone (OR, 5.33; 95%, 4.34–6.55). It was further discovered that G-CSF + plerixafor could mobilize more CD34+ cells into PB, which was beneficial for the next transplantation in both randomized controlled (MD, 18.30; 95%, 8.74–27.85) and single-arm (MD, 20.67; 95%, 14.34–27.00) trials. Furthermore, G-CSF + plerixafor did not cause more treatment emergent adverse events than G-CSF alone (OR, 1.25; 95%, 0.87–1.80).

Conclusions

This study suggests that the combination of G-CSF and plerixafor, resulted in more patients with MM, NHL, and HL, achieving the predetermined apheresis yield of CD34+ cells, which is related to the more effective mobilization of CD34+ cells into PB.

Keywords:

• Plerixafor
• G-CSF
• CD34+ cell
• First-line
• MM
• NHL
• HL

Authors contributions

YYL, XQ, YPL, and RXZ conceived the study. XQ and RXZ conducted the literature search. YYL, YPL, and RXZ screened the full-text papers and extracted the data. YYL, XQ, and YPL run the analysis. XQ and RXZ drafted the manuscript, and all authors provided input into revisions and approved the final draft for submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This is a review study, and no ethical approval is required.

Data availability statement

Data are available to investigators after request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.