Currently submitted to: JMIR Preprints
Date Submitted: Oct 15, 2026
Open Peer Review Period: Oct 15, 2026 - Sep 30, 2027
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Comparison of G-CSF With and Without Plerixafor or Cyclophosphamide for Hematopoietic Stem-Cell Mobilization in Autologous Transplantation: A Retrospective Cohort Study
ABSTRACT
Background:
Autologous hematopoietic stem-cell transplantation (HSCT) requires adequate peripheral blood stem-cell collection. The optimal mobilization regimen remains uncertain, particularly regarding the comparative effects of granulocyte colony-stimulating factor (G-CSF) alone, G-CSF plus plerixafor, and G-CSF plus cyclophosphamide. This study compared cell-collection and short-term transplantation outcomes among patients undergoing autologous HSCT.
Methods:
This retrospective cohort study included 80 patients with hematological malignancies who underwent autologous HSCT at the bone-marrow transplantation unit of Imam Khomeini Hospital, Urmia, Iran, between 2017 and 2022. Patients were classified according to mobilization regimen: G-CSF alone (n=23; 28.8%), G-CSF plus plerixafor (n=24; 30%), or G-CSF plus cyclophosphamide (n=33; 41.3%). Data were extracted from institutional transplantation records and archived medical records. Outcomes included CD34-positive cells, CD3 cells, total cells, admission-to-transplantation and transplantation-to-discharge intervals, neutrophil and platelet engraftment, and febrile days. Categorical and continuous variables were compared using Fisher’s exact test, one-way analysis of variance, and the Kruskal–Wallis test as appropriate; analyses were performed in SPSS version 20.
Results:
Age and sex distributions were not significantly different across regimens (p>0.05). Median CD34-positive cell count and CD34-positive percentage were highest with cyclophosphamide plus G-CSF, without significant differences (p=0.48 and p=0.35, respectively). Mean total cells were highest with plerixafor plus G-CSF (p=0.01), and median CD3 cell count was also highest with plerixafor plus G-CSF (p=0.009). Median neutrophil engraftment was 14 days (interquartile range [IQR], 11.50–26) with G-CSF alone and 11 days (IQR, 10–14) with plerixafor plus G-CSF (p=0.22). Admission-to-transplantation time differed significantly across groups, whereas transplantation-to-discharge time, platelet engraftment, and febrile days did not. Conclusion: In this single-center retrospective cohort, plerixafor plus G-CSF was associated with higher total-cell and CD3-related collection measures, while cyclophosphamide plus G-CSF yielded numerically higher CD34-related measures. Given nonsignificant differences in several clinical outcomes, these findings require confirmation in larger prospective studies.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.