This trial was aimed to explore the efficacy of
pegfilgrastim to accelerate neutrophil engraftment after stem cell autotransplant. Twenty patients with
multiple myeloma and 20 with
lymphoma received
pegfilgrastim 6 mg on day +1. Forty cases treated with daily
filgrastim starting at median day +7 (5-7), matched by age, sex, diagnosis, high-dose
chemotherapy schedule, CD34 + cell-dose, and prior
therapy lines, were used for comparison. Median time to neutrophil engraftment was 9.5 vs. 11 days for
pegfilgrastim and
filgrastim, respectively (p < 0.0001). Likewise, duration of
neutropenia, intravenous
antibiotic use, and hospitalization favored
pegfilgrastim, while platelet engraftment, transfusion requirement, and
fever duration were equivalent in both groups. No grade ≥ 3 toxicities were observed. Patients with
lymphoma performed similarly to the entire cohort, while patients with myeloma showed faster neutrophil engraftment and shorter
neutropenia but not shorter hospitalization and
antibiotic use. The possibility of different outcomes for
lymphoma and myeloma suggests that stratification by diagnosis may be useful in future phase III studies.