title: Delayed G-CSF after autologous progenitor cell transplantation: a prospective randomized trial.
abstract: G-CSF is given after autologous progenitor cell transplantation to accelerate neutrophil engraftment. Historically, G-CSF has been started on the day of progenitor cell infusion. To study the timing of the initiation of G-CSF after autologous peripheral blood progenitor cell (PBPC) transplantation, we conducted a prospective, randomized trial comparing the initiation of G-CSF therapy on day 0, day +3 or day +5 after autologous PBPC transplantation. Seventy patients with diagnoses of breast cancer, non-Hodgkin's lymphoma, Hodgkin's disease, or multiple myeloma were prospectively randomized to one of the three treatment arms. All patients were treated with a chemotherapy (only) preparative regimen. The source of hematopoietic reconstitution was PBPC alone (without autologous marrow), and all patients yielded a minimum of 2 x 10(6) CD34+ cells per kilogram. Times to neutrophil engraftment and platelet engraftment were identical in the three treatment groups, with neutrophil engraftment occurring at a median of 10, 11 and 11 days when starting G-CSF on day 0, day 3 or day 5, respectively. Time to platelet transfusion independence was 14, 11 and 14 days by treatment group. We conclude that delaying the initiation of G-CSF from day 0 to day +5 does not affect engraftment and results in cost savings.
authors.affiliation: Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Bolwell
authors.forename: B
authors.initials: B
authors.lastname: Pohlman
authors.forename: S
authors.initials: S
authors.lastname: Andresen
authors.forename: M
authors.initials: M
authors.lastname: Kalaycio
authors.forename: M
authors.initials: M
authors.lastname: Goormastic
authors.forename: K
authors.initials: K
authors.lastname: Wise
authors.forename: A
authors.initials: A
authors.lastname: Wakeling
authors.forename: R
authors.initials: R
authors.lastname: Dannley
authors.forename: B
authors.initials: B
authors.lastname: Overmoyer
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy; D003363:Cost Control; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000191:economics; D006410:Hematopoiesis / Q000187:drug effects; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D011446:Prospective Studies; D014182:Transplantation, Autologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor