Safety and Efficacy of Cyclophosphamide With Dual Mecapegfilgrastim and On‐Demand Plerixafor for Salvage Mobilization in Patients With Initial Mobilization Failure: A Retrospective Cohort

作者：Fang Huang, Ke Cui, Jie Zhao, Zhichao Li, Yun Qin, Siguo Hao, Jiangbo Wan · 发表于：Journal of Clinical Apheresis · 年份：2026 · DOI：10.1002/jca.70091 · 被引用次数：1 · 研究领域：Hematopoietic Stem Cell Transplantation、Acute Myeloid Leukemia Research、Neutropenia and Cancer Infections

ABSTRACT Initial hematopoietic stem cell (HSC) mobilization failure remains a critical barrier to autologous stem cell transplantation (ASCT) in patients with lymphoma or multiple myeloma (MM). This retrospective cohort study (August 2015 to March 2023) evaluated the efficacy, safety, and cost‐effectiveness of a novel salvage regimen—split‐dose cyclophosphamide (CTX: 1.5 g/m 2 for 2 days) + Mecapegfilgrastim (PEG‐rhG‐CSF) + on‐demand plerixafor (PXF)—compared to conventional strategies (CTX + granulocyte colony‐stimulating factor [G‐CSF] or G‐CSF + PXF) in 118 patients with initial mobilization failure. Patients were stratified into three groups: CTX + PEG‐rhG‐CSF + on‐demand PXF ( n = 46), CTX + G‐CSF ( n = 34), and G‐CSF + PXF ( n = 38). The CTX + PEG‐rhG‐CSF + on‐demand PXF group achieved superior mobilization efficacy: median CD34 + cell yield was 9.2 × 10 6 /kg, which is significantly higher than that of CTX + G‐CSF group (4.1 × 10 6 /kg; p < 0.05) and G‐CSF + PXF group (4.6 × 10 6 /kg; p < 0.05). Rates of achieving the thresholds of ≥ 2 × 10 6 CD34 + cells/kg and ≥ 5 × 10 6 CD34 + cells/kg were significantly higher in the CTX + PEG‐rhG‐CSF + on‐demand PXF group. This superior mobilization efficacy also brought fewer apheresis sessions: only 15.2% of patients in the CTX + PEG‐rhG‐CSF + on‐demand PXF cohort required ≥ 2 sessions, compared to 70.5% in CTX + G‐CSF group and 57.9% in G‐CSF + PXF group ( p < 0.001). Safety profiles were comparable across cohorts: feb...