Otolog Kök Hücre Nakli̇ ni̇ n Bi̇ r Parçasi Olarak Standart Profi̇ lakti̇ k G-CSF Uygulanmasi

Standart Prophylactic Granulocyte Colony Stimulating Factor Usage as a Part of Autologous Stem Cell Transplantati̇ on Procedure

Zübeyde Nur ÖZKURT, Münci YAĞCI, Özlem GÜZEL TUNÇCAN, Lale AYDIN KAYNAR, Zeynep Arzu YEĞİN, Ferda CAN

Özet

Giriş ve Amaç: Otolog hematopoietik kök hücre transplantasyonunun (ASCT) morbidite ve mortalitesinin başlica nedenlerinden biri, uzun süreli nötropeni sirasindaki enfeksiyonlardir. Bu çalişmada ASCT hastalarinda profilaktik G-CSF kullaniminin enfeksiyon sikliği, nötrofil engraftmani ve nötropeni süresi, hastanede kaliş süresi ve nakille ilişkili morbidite ve mortalite üzerine etkisini araştirmayi amaçladik. Yöntem ve Gereçler: G-CSF, birimimizde Şubat 2014'ten itibaren 3 yildir otolog kök hücre nakli sonrasi rutin olarak kullanilmaktadir. Bu çalişmada, uygulamadan üç yil önce ve sonra ardişik oto-HSCT verileri geriye dönük olarak toplanmiştir. Rutin antimikrobiyal profilaksiye ek olarak, G-CSF alan grupta beşinci günden itibaren 5 mcg/kg/gün G-CSF sc başlandi ve nötrofil engraftrasyonuna kadar uygulamaya devam edildi. Bulgular: Çalişmaya toplam 226 hasta (129 erkek, 97 kadin) dahil edildi. Profilaktik G-CSF alan hastalarda nötrofil engraftmani daha erkendi [13 (9-23) ve 12 (10-22) gün] ve nötropeni süresi [11 (5-23) ve 8 (5-19) gün] daha kisaydi (p 0.05).

Abstract

Introduction: One of the major causes of morbidity and mortality of autologous hematopoietic stem cell transplantation (ASCT) is infections during prolonged neutropenia. In this study, we aimed to investigate the effect of prophylactic G-CSF use in ASCT patient on the frequency of infection, duration of neutrophil engraftment and neutropenia, length of hospital stay and transplant-related morbidity and mortality. Methods: G-CSF has been routinely used after autologous stem cell transplantation in our unit for 3 years since February 2014. In this study, three years before and after the application consecutive auto-HSCT data were collected retrospectively. In addition to routine antimicrobial prophylaxis, In the group receiving G-CSF, 5mcg/kg/day G-CSF sc was started from fifth day and application was continued until neutrophil engraftment. Results: A total of 226 patients (129 males, 97 females) were included in the study. In patients receiving prophylactic G-CSF, neutrophil engraftment was earlier [13 (9-23) and 12 (10-22) days], and the duration of neutropenia [11 (5-23) and 8 (5-19) days] was shorter (p 0.05)