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Post-Transplant Complications

G-CSF given after haematopoietic stem cell transplantation using HLA-identical sibling donors is associated to a higher incidence of acute GVHD II–IV

Bone Marrow Transplantation volume 32, pages 217–223 (2003)Cite this article

Summary:

The effect of granulocyte colony-stimulating factor (G-CSF), given after transplantation, was studied in 155 patients transplanted with haematopoietic stem cells (HSCT) from HLA-identical sibling donors at Huddinge University Hospital between 1993 and 2001. Only patients with haematological malignancies were included. Conditioning consisted of total-body irradiation in 118 and busulphan in 37 patients. They were all given methotrexate combined with cyclosporine as graft-versus-host disease (GVHD) prophylaxis. Of the 155 patients, 66 (43%) received G-CSF after HSCT. Those given G-CSF had a significantly shorter time to neutrophil engraftment (P<0.001). G-CSF treatment had no effect on erythrocyte transfusions, platelet engraftment and infections. However, patients treated with G-CSF had a significantly higher incidence of grades II–IV acute GVHD than those not given this treatment (34 vs 9%, P<0.001). The multivariate analysis showed that the effect of G-CSF was independent of other known risk factors for grades II–IV acute GVHD. Death from GVHD occurred in four and two cases (P=0.06) in the two groups, respectively. The cumulative incidences of transplant-related mortality, survival, chronic GVHD, relapse and relapse-free survival were similar in both groups. In conclusion, G-CSF given after HLA-identical sibling HSCT was associated with a higher risk of grades II–IV acute GVHD, but not transplant-related mortality.

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Acknowledgements

This study was sponsored by grants from the Dagmar Ferbs Memorial Foundation, Swedish Medical Society (2001-1299, 2002-727), Swedish Foundation for Medical Research (SSMF), Tore Nilsons Foundation for Medical Research, the Children's Cancer Foundation (2001/012, 1997/073), the Swedish Medical Research Council (K98-06X-05971-18B), Swedish Cancer Society (0070-B97-11XBC), the FRF Foundation and the Tobias Foundation (B11/98).

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Authors and Affiliations

  1. Centre for Allogeneic Stem Cell Transplantation, Huddinge University Hospital, Stockholm, Sweden

    M Remberger, N Naseh, J Aschan, L Barkholt, K LeBlanc, P Svennberg & O Ringdén

  2. Department of Clinical Immunology, Huddinge University Hospital, Stockholm, Sweden

    M Remberger, K LeBlanc & O Ringdén

  3. Department of Haematology, Huddinge University Hospital, Stockholm, Sweden

    J Aschan & K LeBlanc

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Remberger, M., Naseh, N., Aschan, J. et al. G-CSF given after haematopoietic stem cell transplantation using HLA-identical sibling donors is associated to a higher incidence of acute GVHD II–IV. Bone Marrow Transplant 32, 217–223 (2003). https://doi.org/10.1038/sj.bmt.1704108

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