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At-home autologous stem cell transplantation in multiple myeloma with and without G-CSF administration: a comparative study

Bone Marrow Transplantation volume 51, pages 593–595 (2016)Cite this article

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Severe neutropenia remains the main cause of morbidity and mortality after autologous stem cell transplantation (ASCT). Improvements in this procedure, such as the use of peripheral blood progenitor cells and the administration of an oral antibiotic prophylaxis, have reduced the incidence of infections during the time of neutropenia and have made ASCT safer.1, 2, 3 The use of G-CSF after ASCT with the intention of reducing the duration of neutropenia and minimising the risk of severe infection is a common practice in most transplantation centres. In addition, because of a faster neutrophil recovery, G-CSF administration may also be associated with a reduction in the incidence and severity of oral and intestinal mucositis after ASCT.4 However, it has been reported that G-CSF administration after ASCT does not reduce the incidence or duration of febrile neutropenia or the infectious mortality rate.5, 6, 7, 8 Moreover, G-CSF administration has been associated with a higher incidence of clinical complications such as engraftment syndrome (ES) and capillary leak syndrome.9, 10, 11 For these reasons, its use after ASCT is controversial.11, 12 Thus, in May 2011, our centre discontinued the administration of post-transplant G-CSF in patients with multiple myeloma (MM). We hypothesised that the use of G-CSF in these patients does not provide any significant clinical benefit as compared with not using G-CSF. Here we report the results of this policy by comparing two cohorts of patients; one cohort received post-transplant G-CSF, whereas the other cohort did not receive G-CSF.

One hundred ninety-five patients with MM underwent an ASCT between November 2000 and October 2014. Of them, 131 (67%) were not included in an at-home ASCT programme because of ECOG >2 (35%), patient decision (27%), geographic distance (21%) and no caregiver available (17%). Finally, 64 (33%) patients were included. The hospital ethics committee approved this programme and all patients signed a written informed consent.

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Author notes

  1. N Martínez-Cibrian and L Magnano: These authors contributed equally to this work

Authors and Affiliations

  1. Hematology Department, Stem Cell Transplantation Unit, Institute of Hematology and Oncology, Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain

    N Martínez-Cibrian, L Magnano, G Gutiérrez-García, X Andrade, J G Correa, M Suárez-Lledó, C Martínez, M Rovira, E Carreras, L Rosiñol, C F de Larrea, M T Cibeira, A Gaya, C Gallego, A Hernando, J Bladé, Á Urbano-Ispizua & F Fernández-Avilés

  2. Josep Carreras Leukemia Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain

    E Carreras & Á Urbano-Ispizua

  3. Department of Pharmacy, Hospital Clinic, Barcelona, Spain

    N Creus

Authors
  1. N Martínez-Cibrian
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  18. Á Urbano-Ispizua
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  19. F Fernández-Avilés
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Corresponding author

Correspondence to F Fernández-Avilés.

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The authors declare no conflict of interest.

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Cite this article

Martínez-Cibrian, N., Magnano, L., Gutiérrez-García, G. et al. At-home autologous stem cell transplantation in multiple myeloma with and without G-CSF administration: a comparative study. Bone Marrow Transplant 51, 593–595 (2016). https://doi.org/10.1038/bmt.2015.287

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