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Meta-Analysis
. 2024 Dec;56(1):2329140.
doi: 10.1080/07853890.2024.2329140. Epub 2024 Mar 12.

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

Yuyao Li  1   2 , Xia Qiu  1   3 , Yupeng Lei  1   3 , Ruixi Zhou  1   3
Affiliations
Meta-Analysis

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

Yuyao Li et al. Ann Med. 2024 Dec.

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: CD34+ cell; First-line; G-CSF; HL; MM; NHL; Plerixafor.

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Conflict of interest statement

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

Figures

Figure 1.
Figure 1.
Search strategy and study selection.
Figure 2.
Figure 2.
Risk of bias graph in the included studies.
Figure 3.
Figure 3.
Meta-analysis of the proportion of patients achieving the predetermined apheresis yield of CD34+ cells (cells × 106/kg) in the G-CSF + plerixafor group versus the G-CSF group. HL, Hodgkin’s lymphoma; MM, multiple myeloma; NHL, non-Hodgkin’s lymphoma; PB, peripheral blood.
Figure 4.
Figure 4.
Meta-analysis of PB CD34+ cell count (cells/μL) between the G-CSF + plerixafor and G-CSF groups. HL, Hodgkin’s lymphoma; MM, multiple myeloma; NHL, non-Hodgkin’s lymphoma; PB, peripheral blood.
Figure 5.
Figure 5.
Meta-analysis of PB CD34+ cell count (cells/μL) before and after plerixafor administration. PB, peripheral blood. HL, Hodgkin’s lymphoma; MM, multiple myeloma; NHL, non-Hodgkin’s lymphoma.
Figure 6.
Figure 6.
Meta-analysis of the incidence of TEAEs between the G-CSF + plerixafor group versus the G-CSF group. HL, Hodgkin’s lymphoma; MM, multiple myeloma; NHL, non-Hodgkin’s lymphoma; TEAEs, treatment emergent adverse events.
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