The dose of granulocyte-colony-stimulating factor after chemopriming treatment does not influence apheresis yield of progenitor cells: a retrospective study of 91 cases

BACKGROUND: The optimal dose of post-chemotherapy granulocyte-colony-stimul ating factor (G-CSF) administration before peripheral blood progenitor cell (PBPC) collection has not been determined as yet, although 5 mu g per kg p er day has been recommended as the standard dose. This study retrospectivel y analyzed the effect of G-CSF dose on peripheral blood CD34+ cell collecti on from 91 patients with hematologic malignancies. STUDY DESIGN AND METHODS: Various doses of G-CSF were administered after se veral chemotherapeutic PBPC mobilization regimens. According to the dose of G-CSF administered, patients were assigned to two groups. Group 1 included 46 patients who received a low dose of G-CSF (median, 3.6 [range, 2.8-4.6] mu g/kg/day). Group 2 included 45 patients who received a standard G-CSF d ose of 6.0 (5.5-8.1) mu g per kg per day. Patients in the two groups were m atched for age, diagnosis, previous therapy, and chemotherapeutic PBPC mobi lization regimens. RESULTS: No difference was observed in the median number of CD34+ cells har vested from each group. The number of leukapheresis procedures necessary to obtain a minimum of 3 x 10(6) CD34+ cells per kg was the same in both grou ps, and the percentage of patients who failed to achieve adequate PBPC coll ections was similar in the two groups. CONCLUSION:The administration of low-dose G-CSF after chemotherapy appears equivalent to administration of the standard dose in achieving satisfactory PBPC collection. This approach could allow significant savings in medical cost. A randomized and prospective study is necessary, however, to assess t he validity of these conclusions.