Influence of post-transplant recombinant human granulocyte colony-stimulating factor administration on peritransplant morbidity in patients undergoing autologous stem cell transplantation.
This study evaluated of the effect of post-transplant recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration on the parameters of peritransplant morbidity. Three sequential and consecutive cohorts of 20 patients each received either post-transplant rhG-CSF at a dose of 5 micro g/kg/d i.v. in the morning, starting on d 0, d 5, or no rhG-CSF. Patients who received rhG-CSF starting on d 0 and 5 recovered granulocytes more rapidly than those not receiving rhG-CSF (P < 0.001 for ANC >or= 0.5 and 1 x 10(9)/l). RhG-CSF administration was not significantly associated with more rapid platelet engraftment. RhG-CSF administration starting on d 0 and 5 was significantly associated with a decreased duration of fever (P = 0.002 and 0.001 respectively), antibiotic administration (P < 0.001 and 0.006 respectively) and shorter hospitalization (P < 0.001 and 0.001 respectively) compared with the reference group. There was no difference between the d 0 and d 5 arms regarding the parameters of peritransplant morbidity. In conclusion, rhG-CSF administration was associated with a faster granulocyte recovery, shorter hospitalization, and shorter period of fever and non-prophylactic antibiotic administration. This study also showed that starting rhG-CSF administration on d 5 may be as effective as d 0 on the clinical outcome and may be an economical approach in routine clinical practice in this cost-conscious era.
Department of Bone Marrow Transplantation Unit, Ankara Numune Education and Research Hospital, Ankara, Turkey. demirer@medicine.ankara.edu.tr
Taner
T
Demirer
Meltem
M
Ayli
Mehmet
M
Dagli
Rauf
R
Haznedar
Yasemin
Y
Genc
Turgay
T
Fen
Suleyman
S
Dincer
Ekrem
E
Unal
Nazan
N
Gunel
Ertugrul
E
Seyrek
Tulay
T
Ustun
Nilufer
N
Ustael
Mustafa
M
Yildiz
Durdu
D
Sertkaya
Gulsum
G
Ozet
Osman
O
Muftuoglu
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D005334:Fever; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000276:immunology / Q000601:surgery* / Q000628:therapy; D010976:Platelet Count; D011994:Recombinant Proteins; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D000900:Anti-Bacterial Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor