Analysis of the efficacy and safety of prophylactic PEG-rhG-CSF administration prior to CAR-T cell infusion in patients with multiple myeloma
- 1Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, China
Abstract
ObjectiveTo analyze the efficacy and safety of prophylactic administration of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) before chimeric antigen receptor T cell (CAR-T) infusion in patients with multiple myeloma (MM). MethodsA retrospective analysis was conducted on 67 patients with relapsed/refractory multiple myeloma (RRMM) who received B-cell maturation antigen (BCMA)-targeted or BCMA/CD19 dual-targeted CAR-T therapy. Patients were divided into a PEG group (n=32, receiving a single subcutaneous injection of PEG-rhG-CSF one day before infusion) and a control group (n=35) according to whether PEG-rhG-CSF was prophylactically administered before CAR-T cell infusion. Hematopoietic recovery, neutropenia-related outcomes, immune reconstitution, adverse events, CAR-T expansion, efficacy, and hospitalization were compared between the two groups. ResultsThere was no statistically significant difference in the incidence of leukopenia or neutropenia between the two groups. The neutrophil nadir in the PEG group was higher than that in the control group (0.59×109/L vs. 0.20×109/L, P=0.0018), the median time to neutrophil recovery was shorter than that in the control group (15.0 d vs. 20.5 d, P=0.0052), and the duration of neutropenia was shorter than that in the control group (14 d vs. 19 d, P=0.0036). The incidences of agranulocytosis (34.4% vs. 74.3%, P=0.001) and febrile neutropenia (28.1% vs. 65.7%, P=0.0021) in the PEG group were lower than those in the control group. At 1 month after CAR-T cell infusion, the CD3+ and CD8+ T cell counts in the PEG group were higher (both P<0.05). The median hospital stay in the PEG group was significantly shorter than that in the control group (16 d vs. 21 d, P=0.0377). There were no statistically significant differences between the two groups in the incidence or severity of cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, nor in CAR-T expansion, overall response rate, or survival outcomes. ConclusionsProphylactic administration of PEG-rhG-CSF before CAR-T infusion in patients with RRMM is associated with a higher neutrophil nadir, a shorter time to neutrophil recovery, and lower incidences of agranulocytosis and febrile neutropenia. No increase in CAR-T-related adverse events or impairment of short-term antitumor efficacy or prognosis was observed with this intervention.
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BibTeX
@article{jintao2026analysis,
title = {{Analysis of the efficacy and safety of prophylactic PEG-rhG-CSF administration prior to CAR-T cell infusion in patients with multiple myeloma}},
author = {Jintao XU and Ziting GAO and Tingting ZHANG and Yuanjie ZHUANG and Dan GUO and Hongming HUANG},
journal = {Neike lilun yu shijian},
year = {2026},
month = aug,
doi = {10.16138/j.1673-6087.2026.04.05},
url = {https://doi.org/10.16138/j.1673-6087.2026.04.05},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Analysis of the efficacy and safety of prophylactic PEG-rhG-CSF administration prior to CAR-T cell infusion in patients with multiple myeloma
AU - Jintao XU
AU - Ziting GAO
AU - Tingting ZHANG
AU - Yuanjie ZHUANG
AU - Dan GUO
AU - Hongming HUANG
PY - 2026
DA - 2026/08/01
JO - Neike lilun yu shijian
DO - 10.16138/j.1673-6087.2026.04.05
UR - https://doi.org/10.16138/j.1673-6087.2026.04.05
AB - ObjectiveTo analyze the efficacy and safety of prophylactic administration of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) before chimeric antigen receptor T cell (CAR-T) infusion in patients with multiple myeloma (MM). MethodsA retrospective analysis was conducted on 67 patients with relapsed/refractory multiple myeloma (RRMM) who received B-cell maturation antigen (BCMA)-targeted or BCMA/CD19 dual-targeted CAR-T therapy. Patients were divided into a PEG group (n=32, receiving a single subcutaneous injection of PEG-rhG-CSF one day before infusion) and a control group (n=35) according to whether PEG-rhG-CSF was prophylactically administered before CAR-T cell infusion. Hematopoietic recovery, neutropenia-related outcomes, immune reconstitution, adverse events, CAR-T expansion, efficacy, and hospitalization were compared between the two groups. ResultsThere was no statistically significant difference in the incidence of leukopenia or neutropenia between the two groups. The neutrophil nadir in the PEG group was higher than that in the control group (0.59×109/L vs. 0.20×109/L, P=0.0018), the median time to neutrophil recovery was shorter than that in the control group (15.0 d vs. 20.5 d, P=0.0052), and the duration of neutropenia was shorter than that in the control group (14 d vs. 19 d, P=0.0036). The incidences of agranulocytosis (34.4% vs. 74.3%, P=0.001) and febrile neutropenia (28.1% vs. 65.7%, P=0.0021) in the PEG group were lower than those in the control group. At 1 month after CAR-T cell infusion, the CD3+ and CD8+ T cell counts in the PEG group were higher (both P<0.05). The median hospital stay in the PEG group was significantly shorter than that in the control group (16 d vs. 21 d, P=0.0377). There were no statistically significant differences between the two groups in the incidence or severity of cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, nor in CAR-T expansion, overall response rate, or survival outcomes. ConclusionsProphylactic administration of PEG-rhG-CSF before CAR-T infusion in patients with RRMM is associated with a higher neutrophil nadir, a shorter time to neutrophil recovery, and lower incidences of agranulocytosis and febrile neutropenia. No increase in CAR-T-related adverse events or impairment of short-term antitumor efficacy or prognosis was observed with this intervention.
SN - 1673-6087
ER -