The timing of granulocyte-colony-stimulating factor administration after chemotherapy does not affect stem and progenitor cell apheresis yield: a retrospective study of 65 cases

BACKGROUND: The optimal time for postchemotherapy granulocyte-colony stimul ating factor (G-CSF) administration before peripheral blood stem and progen itor cell (PBPC) collection is not well defined. The impact of G-CSF schedu ling on the number of CD34+ cells collected by leukapheresis from 65 patien ts with malignant disease was studied retrospectively. STUDY DESIGN AND METHODS: Chemotherapy was performed on Days 1 and 2 and wa s followed by G-CSF to mobilize PBPCs. In Group 1,30 patients received the first dose of G-CSF immediately after the end of chemotherapy, as commonly recommended. In Group 2, 35 patients received the first G-CSF dose after th e end of chemotherapy (Days 7 or 8). RESULTS: No difference was;observed between the two groups in white cell re covery and the median number of CD34+ cells harvested. The number of leukap heresis procedures necessary to obtain the minimal number of 3 x 10(6) CD34 + cells per kg was the same. The proportion of patients with a failure of P BPC collection was similar, and G-CSF consumption was reduced in Group 2 wi thout increasing infectious risks. CONCLUSION: Early administration of G-CSF after chemotherapy appears not to be a prerequisite for satisfactory PBPC collection. This approach could al low significant savings in terms of medical cost. A randomized and prospect ive study would be necessary, however, to assess the validity of these conc lusions.