SERUM GRANULOCYTE-COLONY-STIMULATING FACTOR (G-CSF) LEVELS AFTER ALLOGENEIC T-CELL-DEPLETED MARROW TRANSPLANTATION

Endogenously produced and exogenously administered granulocyte colony- stinulating factor (G-CSF) has correlated with myeloid engraftment in a number of hematopoietic progenitor cell transplantation settings. Gi ven the increased susceptibility of T cell-depleted (TCD) bone marrow transplants (BMT) to graft failure, a cohort of 36 (21 male and 15 fem ale) recipients of TCD BMT was evaluated prospectively during the firs t month post-transplant for circulating serum G-CSF levels, to examine the correlation between myeloid engraftment and G-CSF levels. All rec ipients of TCD BM had measurable G-CSF levels, with a median peak leve l of 1750 pg/ml (range 540-26 250 pg/ml) occurring at a median of 5 da ys (range 1-18 days) after BM infusion. There was no association betwe en G-CSF kinetics within 1 month post-transplant and the development o f primary non-engraftment or secondary graft failure. One patient with primary non-engraftment and 6 patients with secondary graft failure e xhibited median G-CSF peak levels of 1600 pg/ml and 1850 pg/ml (range 600-16 250 pg/ml) occurring 5 and 5.5 days (range 4-7 days) after BM i nfusion, respectively. Additionally, the patient with primary non-engr aftmnt demonstrated a high G-CSF level in response to a low absolute n eutrophil count (ANC). An inverse relationship between serial G-CSF le vels and concomitant ANC was documented (log G-CSF = 6.19-0.009 ANC, P < 0.001). Higher peak G-CSF levels were associated with older recipie nt age (P = 0.01) and lower BM cell dose (P = 0.02), while administrat ion of anti-thymocyte globulin post-transplant did not alter G-CSF lev els.