G-CSF ADMINISTRATION FOLLOWING PERIPHERAL-BLOOD PROGENITOR-CELL (PBPC) AUTOGRAFT IN LYMPHOID MALIGNANCIES - EVIDENCE FOR CLINICAL BENEFITS AND REDUCTION OF TREATMENT COSTS

Clinical value and costs of G-CSF administration following autograft w ith mobilized peripheral blood progenitor cells (PBPC) were evaluated in two sequential groups of 20 patients each, treated for lymphoid neo plasms in the period February 1993 to January 1996, One group was give n G-CSF (Filgrastim) (5 mu g/kg/day), starting on day +1 until ANC was >500/mu l, the other received no G-CSF, All patients were conditioned with mitoxantrone 60 mg/m(2) + L-PAM 180 mg/m(2) and received large n umbers of PBPC (median of 12 and 13 x 10(6) CD34(+)/kg, respectively), The median time to ANC >500/mu l was 10 days in the G-CSF group vs 14 days in controls (P < 0.0001), G-CSF was associated with a slightly f aster platelet recovery (11 vs 13 days to pits >20 000/mu l, P = 0.09) , Median duration of fever (2.5 vs 5 days, P = 0.028), nonprophylactic antibiotics (8 vs 11 days, P = 0.019), and post-transplant hospitaliz ation (13 vs 16 days, P = 0.0028) were also significantly reduced, The average cost per treatment in the G-CSF group amounted to about US$18 241 as compared to US$21 868 in the control group, implying a cost re duction of approximately 16%, Thus, G-CSF reduced morbidity with cost containment, supporting its use even if autograft is performed with la rge quantities of PBPC.