Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Timing of G-CSF Initiation After Auto PBSCT

Biol Blood Marrow Transplant; ePub 2017 Oct 20; Singh, et al

Publish date:

Patients in whom granulocyte colony-stimulating factor (G-CSF) was initiated based on absolute neutrophil count (ANC) following autologous peripheral blood stem cell transplantation (PBSCT) experienced the same time to neutrophil engraftment as those whose treatment was started earlier, according to a retrospective study involving 100 individuals. Participants received G-CSF either starting on day +5 (n=50) or +12 if ANC was <0.5x109/L (n=50). Among the results:

  • Median start day in the ANC driven group was day +10 (some were treated earlier per physician discretion), vs day +5 in the early group.
  • Median time to neutrophil engraftment was 13 and 12 days, respectively.
  • Time to platelet engraftment, 1-year relapse rates, and 1-year overall survival rates were similar.
  • Febrile neutropenia rates were 90% and 74%, respectively.
  • There was no significant difference in the incidence of positive bacterial cultures or ICU transfer.
  • The duration of G-CSF administration until neutrophil engraftment was 3 and 6 days, respectively.
  • Median length of post-transplantation hospitalization was 16 and 15 days, respectively.

Citation:

Singh A, Parmar S, Patel K, et al. Granulocyte colony-stimulating factor use after autologous peripheral blood stem cell transplantation: Comparison of two practices. [Published online ahead of print October 20, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.10.026.

This Week's Must Reads