Lipegfilgrastim

Ovarian cancer, cervical cancer, and endometrial cancer are the three major malignant tumors in gynecologic oncology, with an increasing incidence rate in recent years. Chemotherapy, radiotherapy, immunotherapy, and targeted therapy remain the mainstays of treatment; however, all may cause varying degrees of myelosuppression, with neutropenia being the most common adverse effect. Notably, the incidence of grade ≥3 neutropenia among gynecologic oncology patients undergoing antitumor therapy is significantly higher than that in patients with other solid tumors, leading to increased risk of severe infections, prolonged hospitalization, and potentially life-threatening complications. Therefore, effective prevention and management of neutropenia are crucial to ensuring treatment adherence and maintaining patients' quality of life. A growing body of evidence has demonstrated the clinical value of long-acting granulocyte colony-stimulating factor (G-CSF) in the prevention and management of neutropenia. Based on the latest evidence in evidence-based medicine, this expert consensus provides an overview of neutropenia commonly encountered during chemoradiotherapy in patients with gynecologic malignancies and highlights its potential impact on treatment outcomes. It then systematically introduces the long-acting G-CSF currently approved by the U.S. Food and Drug Administration (FDA) and Chinese regulatory authorities. The consensus further elaborates on the clinical applications of long-acting G-CSF in the prevention of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN), and presents corresponding recommendations. Additionally, it outlines the differentiated use of long-acting G-CSF in primary and secondary prophylaxis, along with recommended dosing regimens and administration strategies based on recent literature. Potential adverse effects and corresponding management strategies of long-acting G-CSF are also systematically reviewed. To promote the standardized use of long-acting G-CSF in gynecologic cancer treatment, this 2025 edition of the expert consensus has been jointly developed by leading domestic experts, providing comprehensive guidance and evidence-based recommendations for rational clinical use in this field.

This post-hoc study aimed to find out factors affecting graft viable CD34⁺ cell loss during processing and cryopreservation in 129 non-Hodgkin lymphoma (NHL) patients receiving autologous stem cell transplantation (auto-SCT) and the impact of a low (< 2.0 × 10⁶/kg, group A) and a decent number (≥ 2 × 10⁶/kg, group B) of viable CD34⁺ cells infused on the hematologic recovery, progression-free survival (PFS) and overall survival (OS) after auto-SCT.

The median loss of viable CD34⁺ cells during cryopreservation was higher in group A (47% vs. 19%, p < .001). A higher yield of CD34⁺ cells at the first apheresis in group B (p = .002) was linked with greater loss of viable graft CD34⁺ cells after cryopreservation. Filgrastim (FIL) use for mobilization seemed to associate with higher viable CD34⁺ cell loss compared to pegfilgrastim (PEG) or lipegfilgrastim (LIPEG) in both groups (in group A FIL 66 vs. PEG 35%, p = .006; in group B FIL 37 vs. PEG 15 vs. LIPEG 13%, p < .001). Hematologic recovery after auto-SCT was faster in group B. Neither viable CD34⁺ cell loss during storage nor viable CD34⁺ cell number < 2.0 × 10⁶/kg infused affected on PFS or OS.

G-CSF type used in mobilization and mobilization capacity were found to correlate with viable CD34⁺ cell loss during processing and storage. Most importantly, low infused viable CD34⁺ cell count did not seem to impact on PFS or OS.