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• W1996114637 abstract "Background: Colony stimulating factors (CSF) have substantial benefits when administered following autologous bone marrow transplant. With contemporary patient populations, conditioning regimens and supportive care, the value of CSF administration following autologous peripheral blood stem cell transplant (APBSCT) is less established. While CSF may slightly decrease time to neutrophil engraftment, the impact on hospitalization rate, infections and other clinical outcomes is not clear. On 4/1/08, a consensus-based practice change eliminated the routine use of CSF following APBSCT at Mayo Clinic Rochester based on the hypothesis that this would not significantly impact clinical outcomes. Methods: Following IRB approval, a retrospective evaluation was conducted. All adult patients who received an APBSCT between 8/1/2007 and 8/31/2008 were reviewed. Patients were excluded if they refused consent for use of medical records for research, they received a prior transplant, their primary malignancy was amyloidosis or POEMS, or if they received filgrastim as prophylaxis following APBSCT. Baseline demographic characteristics and clinical endpoints were collected including: time to engraftment, number of transfusions, incidence of infection, fever and duration of therapeutic antimicrobials, incidence of engraftment syndrome, and duration of hospitalization and daily follow-up. Results: Of 259 patients reviewed, 140 were included in the analysis (n = 66 in GM-CSF group, n = 74 in no CSF group). 119 patients were excluded: consent refused (n = 4), prior transplant (n = 28), amyloidosis (n = 38), POEMS (n = 10), filgrastim administered (n = 30). The majority of patients had a primary diagnosis of either multiple myeloma or non-Hodgkin lymphoma. Demographic data between groups was similar. Time to neutrophil engraftment was a median of 12 days in the GM-CSF group versus 14 days in the no CSF group (p<0.0001). Other major hematopoietic and infection-related clinical outcomes were not significantly different between groups.Tabled 1Clinical Outcomes with and without Sargramostim (GM-CSF)GM-CSFNo CSFp-valueNeutrophil engraftment in days (median; interquartile range)12 (11-14)14 (12.75-17)< 0.0001Platelet engraftment in days (median; interquartile range)13 (12-15)14 (12.75-15)0.39Red blood cell transfusions (median; interquartile range)3 (2-4)3 (2-4)0.82Platelet transfusions (median; interquartile range)3 (2-6)4 (2-6)0.21Incidence of microbiologically documented infection (%)21320.14Incidence of fever (%)77660.15Incidence of engraftment syndrome (%)350.49Duration of therapeutic antimicrobials in days (median; interquartile range)6 (1.75-8)6 (0-8)0.84Duration of hospitalization in days (median; interquartile range)2.5 (0-10)4 (0-8)0.66Duration of daily follow-up in days (median; interquartile range)18 (16-21)19 (18-23)0.0015 Open table in a new tab Conclusion: Preliminary analysis suggests that eliminating CSF following APBSCT modestly delays neutrophil engraftment but does not significantly impact other clinical outcomes. Analysis of lymphocyte recovery and day 100 mortality between groups is ongoing." @default.
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• W1996114637 date "2009-02-01" @default.
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• W1996114637 title "Clinical Outcomes With and Without Sargramostim (GM-CSF) Post Autologous Peripheral Blood Stem Cell Transplantation" @default.
• W1996114637 doi "https://doi.org/10.1016/j.bbmt.2008.12.131" @default.
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