Bj. Bolwell et al., DELAYED G-CSF AFTER AUTOLOGOUS PROGENITOR-CELL TRANSPLANTATION - A PROSPECTIVE RANDOMIZED TRIAL, Bone marrow transplantation, 21(4), 1998, pp. 369-373
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.