Annals of Hematology

, Volume 71, Issue 2, pp 65–70

Optimal timing of granulocyte colony-stimulating factor (G-CSF) administration after bone marrow transplantation

A prospective randomized study
  • A. Torres Gómez
  • M. A. Jimenez
  • M. A. Alvarez
  • A. Rodriguez
  • C. Martin
  • M. J. Garcia
  • R. Flores
  • J. Sanchez
  • M. J. de la Torre
  • C. Herrera
  • J. Roman
  • P. Gomez
  • F. Martinez
Original Article

DOI: 10.1007/BF01699248

Cite this article as:
Gómez, A.T., Jimenez, M.A., Alvarez, M.A. et al. Ann Hematol (1995) 71: 65. doi:10.1007/BF01699248

Abstract

The positive role of G-CSF in hastening the myeloid recovery of patients undergoing allogeneic bone marrow transplantation (ALLO-BMT) or autologous bone marrow transplantation (ABMT) has recently been established. Considerable knowledge about adequate doses and route of administration has been accumulated in the past few years. Nonetheless, the optimal time to start growth-factor administration remains undetermined. We have performed a stratified study according to the source of hematopoietic progenitors (ALLO-BMT or ABMT), underlying disease and its stage, and acute graft-versus-host disease (GVHD) prophylaxis regimen and randomized patients in two arms: group A, which started G-CSF on day 0 (36 patients), and group B, which started on day +7 post-BMT (39 patients). The same dose (5 Μg/kg/day) and route of administration were employed in both groups. We found no significant differences in the time to reach an absolute neutrophil count (ANC) of 0.1, 0.5, and 1×109/l and 50×109 platelets/l (medians: 10 and 11, 14.5 and 14, 17 and 16, 23 and 24 days, respectively, in groups A and B). We did not find differences in the days of fever or days on antibiotic treatment with less than 1×109/l ANC, rate of bacteriemia, or days of hospitalization in both groups. In contrast, a considerable saving of GCSF in B group was found (mean days of infusion in group A, 18, versus 11 in group B) (p<0.0001). This is equivalent to a saving of 1120 $US per patient. Therefore, early use of G-CSF after BMT is useless and more expensive and provides no advantage over delayed administration.

Key words

Allogeneic bone marrow transplantation Autologous bone marrow transplantation Granulocyte colony-stimulating factor (G-CSF) Hematopoietic recovery 

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • A. Torres Gómez
    • 1
  • M. A. Jimenez
    • 1
  • M. A. Alvarez
    • 1
  • A. Rodriguez
    • 1
  • C. Martin
    • 1
  • M. J. Garcia
    • 1
  • R. Flores
    • 1
  • J. Sanchez
    • 1
  • M. J. de la Torre
    • 1
  • C. Herrera
    • 1
  • J. Roman
    • 1
  • P. Gomez
    • 1
  • F. Martinez
    • 1
  1. 1.Bone Marrow Transplantation Unit, Department of HematologyReina Sofía University HospitalCórdobaSpain

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