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Haemopoietic Growth Factors

A randomized, multicenter study of G-CSF starting on day +1 vs day +5 after autologous peripheral blood progenitor cell transplantation

Bone Marrow Transplantation volume 29, pages 745–751 (2002)Cite this article

Abstract

In order to assess the effect of delaying G-CSF administration after autologous peripheral blood progenitor cell (PBPC) transplantation on the duration of neutropenia, 87 patients were randomized to receive G-CSF 5 μg/kg/day starting on day +1 (n = 45) or +5 (n = 42) following PBPC transplantation, until recovery of the neutrophils. The duration of neutropenia (<0.5 × 109/l) was shorter in the day +1 group (7 vs 8 days; P = 0.02), especially in patients receiving melphalan 200 mg/m2 and CD34+ cell doses >3.0 × 106/kg. These patients had a later onset of neutropenia after transplant. There were no differences in time to neutrophil and platelet engraftment, or in the incidence of fever and documentation of infection. Although the duration of antibiotic therapy (7 vs 10.5 days; P = 0.01) and time to hospital discharge (13 vs 15 days; P = 0.02) were shorter in the day +1 group, these differences could not be predicted by the day of G-CSF initiation in multivariate analysis. Starting G-CSF on day +1 does not result in faster neutrophil engraftment but in later onset and consequently, slightly shorter duration of neutropenia in patients who receive melphalan 200 mg/m2 and CD34+ cell doses >3.0 × 106/kg.

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Author notes

  1. AM de Azevedo

    Present address: CEMO, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil

Authors and Affiliations

  1. University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    AM de Azevedo, M Nucci & A Maiolino

  2. Universidade Estadual de Campinas, Campinas, SP, Brazil

    AC Vigorito, FJP Aranha & CA de Souza

  3. Universidade de São Paulo, Ribeirão Preto, SP, Brazil

    BP Simões & J Voltarelli

  4. CEMO, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil

    DG Tabak

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  1. AM de Azevedo
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de Azevedo, A., Nucci, M., Maiolino, A. et al. A randomized, multicenter study of G-CSF starting on day +1 vs day +5 after autologous peripheral blood progenitor cell transplantation. Bone Marrow Transplant 29, 745–751 (2002). https://doi.org/10.1038/sj.bmt.1703538

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