Abstract
The purpose of the study was to evaluate the effect of delayed granulocyte colony-stimulating factor (G-CSF) use on hematopoietic recovery post-autologous peripheral blood progenitor cell (PBPC) transplantation. Patients were randomized to begin G-CSF on day +1 or day +7 post transplantation. Thirty-seven patients with lymphoma or myeloma undergoing high-dose therapy and autologous PBPC rescue were randomized to daily subcutaneous G-CSF beginning on day +1 or day +7 post-transplant. Patients ⩽70 kg received 300 μg/day and >70 kg 480 μg/day. All patients were reinfused with PBPCs with a CD34+ cell count >2.0 × 106/kg. Baseline characteristics of age, sex and CD34+ cell count were similar between the two arms, the median CD34+ cell count being 5.87 × 106/kg in the day +1 group and 7.70 × 106/kg in the day +7 group (P = 0.7). The median time to reach a neutrophil count of >0.5 × 109/l was 9 days in the day +1 arm and 10 days in the day +7 arm, a difference which was not statistically significant (P = 0.68). Similarly, there was no difference in median days to platelet recovery >20 000 × 109/l, which was 10 days in the day +1 arm and 11 days in the day +7 arm (P = 0.83). There was also no significant difference in the median duration of febrile neutropenia (4 vs 6 days; P = 0.7), intravenous antibiotic use (7 vs 8 days; P = 0.54) or median number of red blood cell transfusions (4 vs 7 units; P = 0.82) between the two arms. Median length of hospital stay was 11 days post-PBPC reinfusion in both groups. The median number of G-CSF injections used was 8 in the day +1 group and 3 in the day +7 group (P < 0.0001). there is no significant difference in time to neutrophil or platelet recovery when g-csf is initiated on day +7 compared to day +1 post-autologous pbpc transplantation. there is also no difference in number of febrile neutropenic or antibiotic days, number of red blood cell transfusions or length of hospital stay. the number of doses of g-csf used per transplant is significantly reduced with delayed initiation, resulting in a significant reduction in drug costs. for patients with an adequately mobilized pbpc graft, the initiation of g-csf can be delayed until day +7 post-pbpc reinfusion.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bence-Bruckler, I., Bredeson, C., Atkins, H. et al. A randomized trial of granulocyte colony-stimulating factor (Neupogen) starting day 1 vs day 7 post-autologous stem cell transplantation. Bone Marrow Transplant 22, 965–969 (1998). https://doi.org/10.1038/sj.bmt.1701469
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1701469
Keywords
This article is cited by
-
Treatment-related mortality following autologous hematopoietic stem cell transplantation is unaffected by timing of G-CSF administration
Bone Marrow Transplantation (2020)
-
Filgrastim-alone versus pegylated filgrastim-alone for autologous peripheral blood stem cells mobilization in newly diagnosed multiple myeloma patients
Wiener klinische Wochenschrift (2017)
-
Performing allogeneic and autologous hematopoietic SCT in the outpatient setting: effects on infectious complications and early transplant outcomes
Bone Marrow Transplantation (2010)
-
Optimal use of G-CSF administration after hematopoietic SCT
Bone Marrow Transplantation (2009)
-
Granulocyte and erythropoietic stimulating proteins after high-dose chemotherapy for myeloma
Bone Marrow Transplantation (2007)