G-CSF POST-AUTOLOGOUS PROGENITOR-CELL TRANSPLANTATION - A RANDOMIZED STUDY OF 5, 10, AND 16 MU-G KG/DAY/

G-CSF is routinely administered after autologous bone marrow or periph eral blood progenitor cell transplantation to enhance neutrophil engra ftment, However, many different doses of G-CSF have been described wit h no clear consensus on the most cost-effective dose, We performed a p rospective randomized trial examining the efficacy of three different doses of G-CSF post-autologous transplant (5, 10, or 16 mu g/kg/day), Fifty-seven consecutive patients with breast cancer (n = 30), non-Hodg kin's lymphoma (n = 16), Hodgkin's disease (n = 6), multiple myeloma ( n = 2), acute leukemia (n = 2), and testicular cancer (n = 1) were ran domized, with 19 patients enrolled in each of the three treatment grou ps, All patients underwent a high-dose chemotherapy preparative regime n and received an autologous peripheral blood progenitor cell (PBPC) t ransplant (without bone marrow), with G-CSF beginning on day 0, There was no difference in time to neutrophil engraftment among the three tr eatment groups (mean 10.2 to 10.8 days), There is a trend towards earl ier platelet engraftment in the patient group receiving 5 mu g/kg/day of G-CSF, The total cost of G-CSF by dose group was $2900, $4400, and $6500 per patient, We conclude that there was no advantage to the use of higher doses of G-CSF after autologous transplantation, and that lo wer doses are associated with lower costs.