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Haemopoietic Growth Factors

Late G-CSF after allogeneic bone marrow or peripheral blood stem cell transplantation: a prospective controlled trial

Abstract

Granulocyte colony-stimulating factor (G-CSF) is widely used to accelerate neutrophil recovery after allogeneic BMT or PBSC transplantation. The optimal time to start G-CSF treatment is not known. Forty-two patients undergoing allogeneic BMT or PBSC transplantation for hematological malignancies received G-CSF either on day 6 or on day 9 post transplant. The time to hematological recovery was monitored and the two groups were compared with respect to peritransplant morbidity and mortality. Recovery of the neutrophil counts to >0.1 × 109/l, > 0.5 × 109/l and >1.0 × 109/l were not significantly different in either group. There was no difference in recovery of red blood cell and platelet counts and no difference between the two groups with respect to the number of febrile days or number of days on antibiotic treatment. Documented bacterial, viral or fungal infections did not occur more often when G-CSF treatment was started on day 9. Delaying treatment with G-CSF resulted in a significant reduction in the length of treatment from 13 to 10 days (23.1% reduction). Reducing the length of the treatment by 3 days lowered the costs by 395.40 Euro per patient. Delaying G-CSF treatment and starting on day 9 after BMT or PBSC transplantation is safe and results in a clear economic benefit.

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References

  1. Lee SJ, Weller E, Alyea EP et al. Efficacy and costs of granulocyte colony-stimulating factor in allogeneic T-cell depleted bone marrow transplantation Blood 1998 92: 2725 2729

    CAS  Google Scholar 

  2. Locatelli F, Pession A, Zecca M et al. Use of recombinant human granulocyte colony-stimulating factor in children given allogeneic bone marrow transplantation for acute or chronic leukemia Bone Marrow Transplant 1996 17: 31 37

    CAS  PubMed  Google Scholar 

  3. Schriber JR, Chao NJ, Long GD et al. Granulocyte colony-stimulating factor after allogeneic bone marrow transplantation Blood 1994 84: 1680 1684

    CAS  Google Scholar 

  4. Gisselbrecht C, Prentice HG, Bacigalupo A et al. Placebo-controlled phase III trial of lenograstim in bone-marrow transplantation Lancet 1994 343: 696 700

    Article  CAS  Google Scholar 

  5. Ciernik IF, Schanz U, Gmur J . Delaying treatment with granulocyte colony-stimulating factor after allogeneic bone marrow transplantation for hematological malignancies: a prospective randomized trial Bone Marrow Transplant 1999 24: 147 151

    Article  CAS  Google Scholar 

  6. Lee KH, Lee JH, Choi SJ et al. Randomized comparison of two different schedules of granulocyte colony-stimulating factor administration after allogeneic bone marrow transplantation Bone Marrow Transplant 1999 24: 591 599

    Article  CAS  Google Scholar 

  7. Torres-Gomez A, Jimenez MA, Alvarez MA et al. Optimal timing of granulocyte colony-stimulating factor (G-CSF) administration after bone marrow transplantation. A prospective randomized study Ann Hematol 1995 71: 65 70

    Article  CAS  Google Scholar 

  8. Przepiorka D, Smith TL, Folloder J et al. Controlled trial of filgrastim for acceleration of neutrophil recovery after allogeneic blood stem cell transplantation from human leukocyte antigen-matched related donors Blood 2001 97: 3405 3410

    Article  CAS  Google Scholar 

  9. ASCO. Update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based clinical practice guidelines J Clin Oncol 1996 14: 1957 1960

  10. Bolwell BJ, Pohlman B, Andresen S et al. Delayed G-CSF after autologous progenitor cell transplantation: a prospective randomized trial Bone Marrow Transplant 1998 21: 369 373

    Article  CAS  Google Scholar 

  11. Faucher C, Le Corroller AG, Chabannon C et al. Administration of G-CSF can be delayed after transplantation of autologous G-CSF-primed blood stem cells: a randomized study Bone Marrow Transplant 1996 17: 533 536

    CAS  Google Scholar 

  12. Körbling M, Anderlini P . Peripheral blood stem cell versus bone marrow allotransplantation: does the source of hematopoietic stem cells matter? Blood 2001 98: 2900 2909

    Article  Google Scholar 

  13. Arpinati M, Green CL, Heimfeld S et al. Granulocyte-colony stimulating factor mobilizes T helper 2-inducing dendritic cells Blood 2000 95: 2484 2490

    CAS  Google Scholar 

  14. Pan L, Delmonte J, Jalonen CK et al. Pretreatment of donor mice with granulocyte colony-stimulating factor polarizes donor T lymphocytes toward type-2 cytokine production and reduces severity of experimental graft-versus-host disease Blood 1995 86: 4422 4429

    CAS  Google Scholar 

  15. Miller JS, Prosper F, McCullar V . Natural killer (NK) cells are functionally abnormal and NK cell progenitors are diminished in granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cell collections Blood 1997 90: 3098 3105

    CAS  Google Scholar 

  16. Volpi I, Perruccio K, Tosti A et al. Postgrafting administration of granulocyte colony-stimulating factor impairs functional immune recovery in recipients of human leukocyte antigen haplotype-mismatched hematopoietic transplants Blood 2001 97: 2514 2521

    Article  CAS  Google Scholar 

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Acknowledgements

We are indepted to Dr Burckhardt Seifert from the Institute for Social and Preventive Medicine, University of Zurich, Switzerland for the statistical analysis.

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Himmelmann, B., Himmelmann, A., Furrer, K. et al. Late G-CSF after allogeneic bone marrow or peripheral blood stem cell transplantation: a prospective controlled trial. Bone Marrow Transplant 30, 491–496 (2002). https://doi.org/10.1038/sj.bmt.1703708

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