Delayed commencement of granulocyte colony-stimulating factor following autologous bone marrow transplantation accelerates neutrophil recovery and is cost-effective

Leuk Lymphoma. 1994 Dec;16(1-2):141-6. doi: 10.3109/10428199409114151.

Abstract

It is known that Granulocyte colony-stimulating factor (G-CSF) accelerates neutrophil recovery following bone marrow transplantation (BMT), though the optimal timing is not clear. We have undertaken a pilot study in 19 recipients of autologous BMT for non-myeloid malignancy, in which G-CSF was commenced 10 (13 cases) or 7 (6 cases) days after BM infusion. These patients were compared with 18 historical controls, who did not receive G-CSF. The median time to achieve both 0.5 and 1.0 x 10(9) neutrophils/Litre was significantly shorter in the treated group (18 and 21 days respectively) than the control group (20.5 and 29 days; p = 0.03 and 0.02 respectively). No differences between the two groups were seen for the number of febrile days, days on antibiotics or the cost of the antibiotics. G-CSF-treated patients remained in hospital for significantly less time after marrow infusion (21 days compared to 29 days; p = 0.007). The cost of the G-CSF therapy was offset by the decreased bed utilisation, so that the median combined antibiotic, G-CSF and hospitalisation cost was 754 pounds less for G-CSF treated patients. It is concluded that delaying the commencement of G-CSF after autologous BMT accelerates neutrophil recovery, and may allow earlier discharge from hospital, whilst not adversely affecting the cost of the procedure.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation* / economics
  • Carboplatin / administration & dosage
  • Combined Modality Therapy
  • Drug Administration Schedule
  • Etoposide / administration & dosage
  • Female
  • Fever / drug therapy
  • Granulocyte Colony-Stimulating Factor / economics
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • Neoplasms / drug therapy
  • Neoplasms / therapy*
  • Neutrophils / cytology*
  • Neutrophils / drug effects*
  • Pilot Projects

Substances

  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • Carboplatin
  • Mitoxantrone