Recombinant human granulocyte colony-stimulating factor (rh-G-CSF) may accelerate hematopoietic recovery after HLA-identical sibling allogeneic peripheral blood stem cell transplantation.
We studied the effects of recombinant human granulocyte colony-stimulating factor (G-CSF) on hematopoietic recovery and clinical outcome in patients undergoing allogeneic peripheral blood stem cell (PBSC) transplantation. Fifty-six patients with hematological malignancies who underwent allogeneic PBSC transplantation between 1995 and 1998 were entered into this study. Twenty-eight patients who received daily G-CSF from day +1 after allogeneic PBSC transplantation until the absolute neutrophil count (ANC) reached >0.5 x 10(9)/l for 3 consecutive days were compared with 28 patients (control group) who did not receive G-CSF in a non-randomized manner. The study group and the control group were comparable with respect to baseline patient and transplantation characteristics. Median times to ANC of >0.5 x 10(9)/l and 1 x 10(9)/l with or without G-CSF were 12 days (range 8-21), 13 days (10-32) (P = 0.04) and 13 days (9-21), 15 days (11-44) (P = 0.02), respectively. Median times to reach a platelet count of >20 x 10(9)/l with and without G-CSF were 11 days (0-20) and 13 days (9-26), respectively (P = 0.03). The incidence of febrile episodes was significantly lower with G-CSF, 75% vs 100% (P = 0.008). Patients receiving G-CSF had less grade III-IV mucositis than those who did not receive G-CSF (P = 0.01). There was also no increase in the incidence and severity of acute GVHD in patients using G-CSF (P = 0.22). Although the number of relapsing patients was greater in the G-CSF group (seven vs three patients), this was not statistically significant (P = 0.24). Disease-free and overall survival rates did not differ between the two groups (P = 0.58 and 0.53, respectively). The administration of G-CSF after allogeneic PBSC transplantation provided faster neutrophil and platelet engraftment associated with less severe mucositis and less febrile episodes.
Ozcan
M
M
Ankara University School of Medicine, Department of Hematology, Ankara, Turkey.
Ustün
C
C
Akçağlayan
E
E
Akan
H
H
Arslan
O
O
Ilhan
O
O
Beksaç
M
M
Gürman
G
G
Demirer
T
T
Arat
M
M
Celebi
H
H
Konuk
N
N
Uysal
A
A
Koç
H
H
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006086:Graft vs Host Disease; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D019337:Hematologic Neoplasms / Q000628:therapy; D006410:Hematopoiesis / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D006648:Histocompatibility; D006801:Humans; D007239:Infections; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family; D011994:Recombinant Proteins; D012008:Recurrence; D015996:Survival Rate; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor