Recombinant human granulocyte colony-stimulating factor (rh-G-CSF) may accelerate hematopoietic recovery after HLA-identical sibling allogeneic peripheral blood stem cell transplantation

We studied the effects of recombinant human granulocyte colony-stimulating factor (G-CSF) on hematopoietic recovery and clinical outcome in patients u ndergoing allogeneic peripheral blood stem cell (PBSC) transplantation. Fif ty-six patients with hematological malignancies who underwent allogeneic PB SC transplantation between 1995 and 1998 were entered into this study. Twen ty-eight patients who received daily G-CSF from day +1 after allogeneic PBS C transplantation until the absolute neutrophil count (ANC) reached >0.5 x 10(9)/l for 3 consecutive days were compared with 28 patients (control grou p) who did not receive G-CSF in a non-randomized manner. The study group an d the control group were comparable with respect to baseline patient and tr ansplantation characteristics. Median times to ANC of >0.5 x 10(9)/l and 1 x 10(9)/l with or without G-CSF were 12 days (range 8-21), 13 days (10-32) (P = 0.04) and 13 days (9-21), 15 days (11-44) (P = 0.02), respectively, Me dian times to reach a platelet count of >20 x 10(9)/l with and without G-CS F were 11 days (0-20) and 13 days (9-26), respectively (P = 0.03), The inci dence of febrile episodes was significantly lower with G-CSF, 75% vs 100% ( P = 0.008), Patients receiving G-CSF had less grade III-IV mucositis than t hose who did not receive G-CSF (P = 0.01), There was also no increase in th e incidence and severity of acute GVHD in patients using G-CSF (P = 0.22), Although the number of relapsing patients was greater in the G-CSF group (s even vs three patients), this was not statistically significant (P = 0.24), Disease-free and overall survival rates did not differ between the two gro ups (P = 0.58 and 0.53, respectively). The administration of G-CSF after al logeneic PBSC transplantation provided faster neutrophil and platelet engra ftment associated with less severe mucositis and less febrile episodes.