1. ¹Department of Pharmacy, University of California, San Diego (USCD), La Jolla, CA, USA
2. ²Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA
3. ³Blood and Marrow Transplantation Division, Department of Medicine, UCSD, La Jolla, CA, USA

Correspondence: Dr M Trivedi, Moores Cancer Center, San Diego Medical Center, University of California, 3855 Health Sciences Dr, #0845, La Jolla, CA 92093-0845, USA. E-mail: mvtrivedi@ucsd.edu

Received 23 October 2008; Revised 16 February 2009; Accepted 24 February 2009; Published online 13 April 2009.

Abstract

After hematopoietic SCT (HSCT), G-CSF is commonly used to enhance stem cell engraftment to minimize the morbidity and mortality associated with prolonged neutropenia. However, there is no consensus on the optimal use of G-CSF after high-dose chemotherapy followed by HSCT. This review was performed to evaluate the evidence regarding the use of G-CSF after autologous and allogeneic HSCT. Studies investigating the use of G-CSF in comparison to control (observation or placebo), early vs delayed initiation of G-CSF, and other approaches driven by patient-specific parameters to identify optimal use of G-CSF have been reviewed. Various outcomes such as neutrophil and platelet engraftment, post-transplant length of hospital stay, post-transplant complications such as infection and GVHD, and survival have been assessed. Finally, we provide the level of evidence for each of the outcomes analyzed while evaluating strategies for using G-CSF in patients undergoing autologous or allogeneic HSCT.