Transplantation without growth factor: engraftment kinetics after stem cell transplantation for primary systemic amyloidosis (AL)

Bone Marrow Transplant. 2007 Nov;40(10):989-93. doi: 10.1038/sj.bmt.1705848. Epub 2007 Sep 10.

Abstract

Stem cell transplantation is increasingly used in the management of immunoglobulin light-chain amyloidosis (AL). It is considered the standard of care to administer growth factors to accelerate neutrophil recovery after transplantation. However, unique toxicities occur with growth factor use in patients with AL who receive a stem cell transplant. We report a cohort of patients who underwent transplantation without receiving posttransplantation growth factors. In total, 282 patients received a stem cell transplant. A neutrophil count of 500/mul was achieved in 50, 75 and 90% of patients at 14, 16 and 22 days, respectively. A platelet count of 20 000/mul was achieved in 50, 75 and 90% of patients at 14, 20 and 31 days, respectively. Non-staphylococcal bacteremia was detected in 16% of patients. The median hospital stay was 9 days. It is feasible and reasonable to withhold growth factor therapy after autologous stem cell transplantation in patients with AL.

MeSH terms

  • Amyloidosis / therapy*
  • Bacteremia / epidemiology
  • Cohort Studies
  • Female
  • Filgrastim
  • Graft Survival*
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Minnesota / epidemiology
  • Recombinant Proteins
  • Stem Cell Transplantation* / adverse effects

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim