Objective  To explore the efficacy of the steady-state mobilization regimen of plerixafor plus mecapegfilgrastim for autologous peripheral blood hematopoietic stem cell (PBSC) mobilization in patients with lymphoma and multiple myeloma (MM).

  Method  This retrospective study analyzed the data of 50 patients with lymphoma and MM admitted for autologous PBSC mobilization to Mianyang Central Hospital from April 2016 to April 2023. Mobilization was performed using one of the following steady-state mobilization protocols: plerixafor plus mecapegfilgrastim (P+Mecapeg), plerixafor combined with recombinant human granulocyte colony-stimulating factor (P+rhG-CSF), and mecapegfilgrastim alone (Mecapeg). This study involves the comparison of hematopoietic stem cell mobilization and hematopoiesis reconstruction after transplantation within three distinct steady-state mobilization groups. Additionally, it seeks to identify risk factors associated with collection failure.

  Results  Among the 50 cases, 25 (50.0%) received P+Mecapeg, 12 (24.0%) received P+rhG-CSF, and 13 (26.0%) received Mecapeg treatment. The success rate of mobilization in the P+Mecapeg, P+rhG-CSF, and Mecapeg alone groups were 100%, 83.3%, and 76.9%, respectively. The median counts of CD34+ cells collected among the three groups were 4.23×10⁶/kg, 3.43×10⁶/kg, and 3.16×10⁶/kg, respectively, while the median time of collections were 1, 1.5, and 2 days, respectively. Mononuclear cell count on the day of the first apheresis in the P+Mecapeg group was higher than in the P+rhG-CSF (P=0.030) and Mecapeg alone (P=0.005) groups. The success rate of PBSC collection in the P+Mecapeg group was higher than in the Mecapeg alone group (P=0.034), and the P+Mecapeg regimen had a higher success rate of mobilization (P=0.025). Binary Logistic regression analysis showed that first-line autologous hematopoietic stem cell transplantation (ASCT) was an independent protective factor for PBSC collection success (P=0.008, OR=36, 95%CI: 2.585–501.268). Among the above patients, 36 cases completed ASCT, including 19 cases in the P+Mecapeg group and 17 cases in the control groups (P+rhG-CSF and Mecapeg alone). In both P+Mecapeg and control groups, the median time to neutrophil engraftment was 10 days, and the platelet engraftment was achieved in a median of 12 days. No statistically significant difference in hematopoietic reconstruction between the two groups was observed.

  Conclusions  Plerixafor plus mecapegfilgrastim is an effective and safe alternative PBSC steady-state mobilization strategy that can effectively improve the success rate of PBSC mobilization in patients with lymphoma and MM. PBSC mobilization and collection at first-line ASCT can significantly increase the success rate of PBSC collection in patients with lymphoma and MM.