Delaying treatment with granulocyte colony-stimulating factor after allogeneic bone marrow transplantation for hematological malignancies: a prospective randomized trial

Optimal use of G-CSF administration after hematopoietic SCT

“…12,13,55,57,58,62 Some studies did not report the route or dose used in their studies. 56,60 The criteria for discontinuing G-CSF treatment after allogeneic transplant was variable in these studies: on the day of ANC 4500/ml; 58 or after ANC 4500/ml  2 days; 62,63 or after ANC 4500/ml  3 days 13,60 or ANC 41000/ml  3 days 12,57,64,65 or ANC 43000/ml  1 day. 55 Owing to the small number of studies, we overlooked the variability of the parameters mentioned above in various studies and assume that the outcomes analyzed below are not influenced by this variability.…”

“…Most of the studies addressing the optimal time to initiate G-CSF were conducted in patients receiving BM products; [63][64][65]68 however, one study also included patients receiving allogeneic PBSCT 68 (Table 6). Filgrastim was the most commonly used growth factor, whereas two studies used lenograstim at a dose of 263 mg per day.…”

“…The studies, including three RCTs in the BMT setting, did not find a significant difference in the time to neutrophil engraftment when giving G-CSF early (day 0 to þ 4) vs late (Xday þ 5) after allogeneic transplantation. [63][64][65]68 In most of the studies, neutrophil engraftment was achieved by day þ 16 to day þ 18. There was also no difference in the time to plt engraftment, incidence of acute GVHD or post-transplant hospital stay between the early and delayed initiation of G-CSF.…”

“…64 The criteria for discontinuing G-CSF treatment after transplant was variable: on the day of Use of G-CSF after HSCT M Trivedi et al ANC 4500/ml  2 days, 63 ANC 41000/ml, 68 or WBC 41000/ml  3 days. 64,65 Outcomes. The studies, including three RCTs in the BMT setting, did not find a significant difference in the time to neutrophil engraftment when giving G-CSF early (day 0 to þ 4) vs late (Xday þ 5) after allogeneic transplantation.…”

Late G-CSF after allogeneic bone marrow or peripheral blood stem cell transplantation: a prospective controlled trial

“…Several randomized studies have addressed this issue. [5][6][7] The study by Torres-Gomez et al 7 found no significant difference in neutrophil recovery and infectious complications in patients who started to receive G-CSF either on day 0 or day 7 post BMT. Similarly, a study from our own group showed that delaying treatment with G-CSF from day 1 to day 6 post BMT reduced treatment time and costs without an adverse effect on hematological recovery or rate of infectious complications.…”