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Economic Analysis

Cost effectiveness of day 5 G-CSF (Lenograstim®) administration after PBSC transplantation: results of a SFGM-TC randomised trial

Bone Marrow Transplantation volume 36, pages 547–552 (2005)Cite this article

Summary:

This randomised trial was designed to compare two groups treated with different G-CSF administration schedules with a third group receiving no G-CSF, after autologous peripheral blood stem cell transplantation (APBSCT). Children and adults with haematological malignancies or solid tumours were randomly assigned to receive either 150 μg/m2/day of Lenograstim starting on day 1 (G1) or on day 5 (G5) post APBSCT, or no Lenograstim (G0). Randomisation was stratified according to the conditioning regimen (Busulfan vs TBI vs no Busulfan and no TBI) and the graft CD 34+ cell count. A total of 240 patients were randomised; 239 were evaluable. All three patient groups were comparable. Median duration of neutropenia was 9 days (4–40), and 10 days (5–15) in the G1 and G5 groups, respectively, significantly shorter than in the G0 group, 13 days (7–36) (P<0.0001). No difference was observed in the duration of thrombocytopenia, transfusion support and extra-haematological complications. The duration of post transplant hospitalisation was significantly shorter in adults who received G-CSF. Clinical and cost arguments favour the initiation of G-CSF on day 5 in adults. The same policy could be applied in children given that clinical management is easier and costs are similar.

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References

  1. Hartmann O, Le Corroller AG, Blaise D et al. Peripheral blood stem cell and bone marrow transplantation for solid tumors and lymphomas: hematologic recovery and costs. A randomized, controlled trial. Ann Intern Med 1997; 126: 600–607.

    Article  CAS  Google Scholar 

  2. Bearman SI, Appelbaum FR, Buckner CD et al. Regimen-related toxicity in patients undergoing bone marrow transplantation. J Clin Oncol 1988; 6: 1562–1568.

    Article  CAS  Google Scholar 

  3. Bolwell B, Goormastic M, Dannley R et al. G-CSF post-autologous progenitor cell transplantation: a randomized study of 5, 10, and 16 micrograms/kg/day. Bone Marrow Transplant 1997; 19: 215–219.

    Article  CAS  Google Scholar 

  4. Bensinger W, Appelbaum F, Rowley S et al. Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol 1995; 13: 2547–2555.

    Article  CAS  Google Scholar 

  5. Faucher C, Le Corroller AG, Chabannon C et al. Autologous transplantation of blood stem cells mobilized with filgrastim alone in 93 patients with malignancies: the number of CD34+ cells reinfused is the only factor predicting both granulocyte and platelet recovery. J Hematother 1996; 5: 663–670.

    Article  CAS  Google Scholar 

  6. Schmitz N, Ljungman P, Cordonnier C et al. Lenograstim after autologous peripheral blood progenitor cell transplantation: results of a double-blind, randomized trial. Bone Marrow Transplant 2004; 34: 955–962.

    Article  CAS  Google Scholar 

  7. Hornedo J, Sola C, Solano C et al. Multicentric prospective, randomized study of the role of filgrastim (G-CSF) after transplant of hematopoietic progenitor cells mobilized with G-CSF in patients with cancer of the breast. Sangre (Barc) 1997; 42 (Suppl. 1): 54–56.

    Google Scholar 

  8. Linch DC, Milligan DW, Winfield DA et al. G-CSF after peripheral blood stem cell transplantation in lymphoma patients significantly accelerated neutrophil recovery and shortened time in hospital: results of a randomized BNLI trial. Br J Haematol 1997; 99: 933–938.

    Article  CAS  Google Scholar 

  9. McQuaker IG, Hunter AE, Pacey S et al. Low-dose filgrastim significantly enhances neutrophil recovery following autologous peripheral-blood stem-cell transplantation in patients with lymphoproliferative disorders: evidence for clinical and economic benefit. J Clin Oncol 1997; 15: 451–457.

    Article  CAS  Google Scholar 

  10. Kawano Y, Takaue Y, Mimaya J et al. Marginal benefit/disadvantage of granulocyte colony-stimulating factor therapy after autologous blood stem cell transplantation in children: results of a prospective randomized trial. The Japanese Cooperative Study Group of PBSCT. Blood 1998; 92: 4040–4046.

    CAS  Google Scholar 

  11. Ojeda E, Garcia-Bustos J, Aguado M et al. A prospective randomized trial of granulocyte colony-stimulating factor therapy after autologous blood stem cell transplantation in adults. Bone Marrow Transplant 1999; 24: 601–607.

    Article  CAS  Google Scholar 

  12. Lee SM, Radford JA, Dobson L et al. Recombinant human granulocyte colony-stimulating factor (filgrastim) following high-dose chemotherapy and peripheral blood progenitor cell rescue in high-grade non-Hodgkin's lymphoma: clinical benefits at no extra cost. Br J Cancer 1998; 77: 1294–1299.

    Article  CAS  Google Scholar 

  13. 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 

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Acknowledgements

We thank the Société Française de Greffe de Moëlle et de Thérapie Cellulaire for promoting this study and Lorna Saint Ange for editing. We thank the other investigators who participated in this study: Dr B Audhuy, Pr P Bordigoni, Pr P Colombat, Dr C Coze, Pr B Desablens, Dr V Gandemer, Dr P Henon, Dr F Lefrère, Pr M Michallet, Dr AM Peny and Pr D Plantaz. This study was performed by the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC). This study was supported by Chugai & Aventis Pharmaceutical Co, Paris, France.

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Authors and Affiliations

  1. Paediatrics Department, Institut Gustave Roussy, Villejuif, France

    D Valteau-Couanet

  2. Institut Paoli Calmette, Marseille, France

    C Faucher

  3. Statistics Department, Institut Gustave Roussy, Villejuif, France

    A Aupérin, A Pinna & E Benhamou

  4. Institut Curie, Paris, France

    J Michon

  5. CHU Nantes, France

    N Milpied

  6. CHU Bordeaux, France

    J M Boiron

  7. Adult Medicine Department, Institut Gustave Roussy, Villejuif, France

    J H Bourhis

  8. St Louis Hospital, Paris, France

    C Gisselbrecht

  9. La Pitié Hospital, Paris, France

    J P Vernant

  10. Laboratoires Chugai & Aventis, Paris, France

    B Bendahmane & F Delabarre

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  1. D Valteau-Couanet
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Correspondence to D Valteau-Couanet.

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Valteau-Couanet, D., Faucher, C., Aupérin, A. et al. Cost effectiveness of day 5 G-CSF (Lenograstim®) administration after PBSC transplantation: results of a SFGM-TC randomised trial. Bone Marrow Transplant 36, 547–552 (2005). https://doi.org/10.1038/sj.bmt.1705097

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  • DOI: https://doi.org/10.1038/sj.bmt.1705097

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