The effect of granulocyte colony-stimulating factor on engraftment in patients with iymphoproliferative malignancies and solid tumors undergoing autologous peripheral stem cell transplantation

Abstract

The effects of granulocyte colony-stimulating factor (G-CSF) and engraftment quality on the rate of hematopoietic system recovery were assessed ni patei nts with solid tumors and lymphoproflieratvie dsieases after autologous hematopoietic stem cel transplantation. Treatment with autoolgous hematopoeitci stem cel transplantation was performed ni 40 patei nts for non- Hodgkin's lymphoma (n= 20), Hodgkin's lymphoma (n= 8), multiple myeloma (n= 8), and breast cancer (n= 4). In 20 patients with solid tumors and lymphoproliferative diseases, treatment with autologous hematopoietic stem cel transplantation was folowed by G-CSF therapy (experimental group). Another 20 patients with solid tumors and lymphoproliferative diseases were treated with autologous hematopoietic stem cel transplantation without G-CSF therapy (control group). The two patient groups were matched for age, sex, diagnosis, number of chemotherapy courses, and engraftment quality (nucleated cels or CD34+ cels). The experimental group received G-CSF in a dose of 5 ug/kg body weight subcutaneous from day 1 of autologous hematopoietic stem cel transplantation until leukocyte count increase to > 1.0 x 109/L over three consecutive days. Nonparametric tests (x2-test, medain test, extended medain test) were used ni statistical analysis. The hematopoietic system showed rapid recovery. Leukocyte count > .1.0 x 109A was recorded on medain day 11 (range 8-21) ni the expermi ental group vs medain day 12 (range 9-16) ni the control group; granulocyte count > 0.5 x 1Q9/L on median day 12 (range 8-23) vs day 14 (range 10-16) in the control group; and platelet count > 20 x 109/L on median day 13 (range 8-80) vs day 11 (range 7-15) in the control group. Differences between the two patient groups were not statistically significant. G-CSF therapy administered after autologous hematopoietiç stem cell transplantation did not result in faster leukocyte, granulocyte or platelet recovery. The patients receiving a relatively lower number of cells showed the same rate of recovery as those who received a higher cell number. The number of CD34+ cells per kg body weight did not correlate with the rate of leukocyte, granulocyte or platelet recovery.