A prospective randomized trial of Filgrastim (r-metHuG-CSF) given at different times after unrelated bone marrow transplantation

A study was done to compare treatment with Filgrastim (r-metHuG-CSF) given at three different times after unrelated bone marrow transplantation (BMT), Sixty-nine patients grafted with HLA-A, -B and -DR-compatible unrelated bo ne marrow were randomized to Filgrastim (5 mu g/kg/day) starting on day 0 ( n = 23), day +5 (n = 23) or day +10 (n = 23) after BMT. No significant diff erences were detected in hematological recovery, days with fever, days on a ntibiotics, incidence of bacteremia or need for erythrocyte, platelet and g ranulocyte transfusions between the three groups. Patients given Filgrastim starting on day 0, day +5 or day +10, respectively, reached an absolute ne utrophil count (ANC) >0.5 x 10(9)/I on a median of 17, 16 and 16 days after BMT, Starting Filgrastim treatment on day +10, rather than on day 0, reduc ed the costs of Filgrastim by $1060, with no significant change in the medi an number of days-to-hospital discharge in the three Filgrastim-treated gro ups. The incidences of acute and chronic GVHD, transplantation-related mort ality, relapse, leukemia-free survival and patient survival (PS) were simil ar in all groups.