International Journal of Hematology

, Volume 93, Issue 6, pp 765–770

Successful neutrophil engraftment by reduced use of granulocyte colony-stimulating factor after allogeneic hematopoietic stem cell transplantation with mycophenolate mofetil for graft-versus-host disease prophylaxis

  • Atsuo Okamura
  • Kimikazu Yakushijin
  • Yumiko Inui
  • Yohei Funakoshi
  • Yuriko Kawamori
  • Takanobu Shimada
  • Masanori Toyoda
  • Naoko Chayahara
  • Naomi Kiyota
  • Yutaka Fujiwara
  • Toru Mukohara
  • Hiroshi Matsuoka
  • Katsuya Yamamoto
  • Hironobu Minami
Original Article

DOI: 10.1007/s12185-011-0852-5

Cite this article as:
Okamura, A., Yakushijin, K., Inui, Y. et al. Int J Hematol (2011) 93: 765. doi:10.1007/s12185-011-0852-5
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Abstract

In allogeneic hematopoietic stem cell transplantation (allo-SCT), most physicians in Japan utilize granulocyte colony-stimulating factor (G-CSF) at a high dose (HD) of 300 μg/m2 per day for filgrastim to promote faster neutrophil engraftment. However, the necessity of the HD has not been validated under graft-versus-host disease (GVHD) prophylaxis by mycophenolate mofetil (MMF), which can also be expected to facilitate engraftment. In a total of 51 patients, we compared the clinical outcomes between a standard dose (SD) fixed at 300 μg per day and a HD of G-CSF. While time to neutrophil engraftment was not different in the HD and SD groups in patients receiving cord blood transplantation (CBT, 20 vs. 17.5 days, P = 0.243) or bone marrow transplantation (BMT, 11 vs. 10 days, P = 0.227), there seemed to be an increased risk of developing acute GVHD in the HD group with CBT (20 vs. 0%, P = 0.073) and BMT (57 vs. 24%, P = 0.165). Progression-free survival of patients in the HD group was likely to be worse compared with that of the SD group with CBT (P = 0.099). In this study, the clinical benefits of a HD of G-CSF could not be documented, and we find that the use of G-CSF at a SD after allo-SCT with MMF should be prospectively evaluated.

Keywords

Mycophenolate mofetilGranulocyte colony-stimulating factorNeutrophil engraftmentGraft-versus-host diseaseProgression-free survival

Copyright information

© The Japanese Society of Hematology 2011

Authors and Affiliations

  • Atsuo Okamura
    • 1
  • Kimikazu Yakushijin
    • 1
  • Yumiko Inui
    • 1
  • Yohei Funakoshi
    • 1
  • Yuriko Kawamori
    • 1
  • Takanobu Shimada
    • 1
  • Masanori Toyoda
    • 1
  • Naoko Chayahara
    • 1
  • Naomi Kiyota
    • 1
  • Yutaka Fujiwara
    • 1
  • Toru Mukohara
    • 1
  • Hiroshi Matsuoka
    • 1
  • Katsuya Yamamoto
    • 1
  • Hironobu Minami
    • 1
  1. 1.Division of Medical Oncology/Hematology, Department of MedicineKobe University Graduate School of MedicineKobeJapan