DELAYED G-CSF AFTER AUTOLOGOUS PROGENITOR-CELL TRANSPLANTATION - A PROSPECTIVE RANDOMIZED TRIAL

G-CSF is given after autologous progenitor cell transplantation to acc elerate neutrophil engraftment, Historically, G-CSF has been started o n the day of progenitor cell infusion, To study the timing of the init iation of G-CSF after autologous peripheral blood progenitor cell (PBP C) transplantation, we conducted a prospective, randomized trial compa ring the initiation of G-CSF therapy on day 0, day +3 or day +5 after autologous PBPC transplantation. Seventy patients with diagnoses of br east cancer, non-Hodgkin's lymphoma, Hodgkin's disease, or multiple my eloma were prospectively randomized to one of the three treatment arms , All patients were treated with a chemotherapy (only) preparative reg imen, The source of hematopoietic reconstitution was PBPC alone (witho ut autologous marrow), and all patients yielded a minimum of 2 x 10(6) CD34(+) cells per kilogram, Times to neutrophil engraftment and plate let engraftment were identical in the three treatment groups, with neu trophil engraftment occurring at a median of 10, 11 and 11 days when s tarting G-CSF on day 0, day 3 or day 5, respectively, Time to platelet transfusion independence was 14, 11 and 14 days by treatment group, W e conclude that delaying the initiation of G-CSF from day 0 to day +5 does not affect engraftment and results in cost savings.