G-CSF AFTER PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION IN LYMPHOMA PATIENTS SIGNIFICANTLY ACCELERATED NEUTROPHIL RECOVERY AND SHORTENED TIME IN-HOSPITAL - RESULTS OF A RANDOMIZED BNLI TRIAL

We have undertaken a prospective randomized study in 90 patients with relapsed or resistant lymphomas to assess the value of G-CSF (lenogras tim) in the acceleration of myeloid recovery after peripheral blood st em cell transplantation (PBSCT), A common regimen of cyclophosphamide 1.5 g/m(2) on day 1 and lenograstim 263 mu g s.c. on days 2-10 with tw o aphereses on days 10 and 11 was used for stem cell mobilization, 77% of patients achieved an adequate PBSC collection in two harvests (>2 x 10(8) MNC/kg or >2 x 10(6) CD34(+) cells/kg). 65 patients went on to receive high-dose BEAM chemotherapy and engraftment data was availabl e for 62. 34 patients had been randomized to receive lenograstim 263 m u g/d s.c. and 28 to no growth factor. The median time to ANC > 5 x 10 (9)/l was 9 d in the lenograstim arm versus 12.5 d in the no-lenograst im arm (P = 0.0001). This was associated with a median duration of tim e in hospital post PBSCT of 13 d in the lenograstim arm versus 15.5 d in the no-lenograstim arm (P = 0.0002). Median days to platelet indepe ndence, platelet transfusions, incidence of infection and red cell tra nsfusion were the same in both arms. These data indicate that lenogras tim significantly accelerated myeloid recovery after PBSCT and shorten ed the duration of hospital stay.