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- W2051220026 abstract "The 2000 ASCO guidelines recommend the use of colony stimulating factors (CSFs) after autologous peripheral blood stem cell transplantation (aPBSCT); however, the need for CSFs for patients (pts) with adequate CD34+ cell content in their grafts has not been established. Prior to 9/01, we initiated GCSF 5mcg/kg of IBW beginning on D+6 only for pts with CD34+ doses of less than 6 × 106/kg; since 9/01, that threshold was reduced to 4.5 × 106/kg. Methods: We conducted a retrospective review of 43 aPBSCT pts from 9/99 through 5/03 with cell doses between 4.5–6 × 106/kg, 20 of whom had received GCSF (CSF) and 23 of whom had not (w/o CSF). The groups were matched for age, sex, diagnosis, prior chemotherapies, conditioning regimens, and mobilization regimens. T-test was used to analyze the data. Results: CSF pts had significantly earlier ANC engraftment, shorter duration of neutropenia, shorter hospital stays, and fewer days of IV antibiotics, as shown below in Table. A significant difference was not found for median days of fever, 1 in CSF pts vs 2 in pts w/o CSF (p = 0.31), or median day of platelet engraftment, 13.5 (range 10–74) vs 17 (range 11–30), p = 0.29. Significantly more pts with prior radiation therapy (RT) were in the group w/o CSF than in the CSF group (8 vs 1, p 0.02); however, RT was not found to be a risk factor for delayed engraftment, prolonged neutropenia, or length of stay. Conclusion: CSF use in aPBSCT pts with CD34+ cell dose <6 × 106/kg results in earlier engraftment, shorter neutropenia, and shorter hospital stay. Based on the average wholesale price of GCSF and the daily cost of hospitalization for aPBSCT pts, the cost of using GCSF in this population is $1500 per patient vs $4400 for 3 extra days of hospital stay. CSFs should therefore be used post-aPBSCT in pts with CD34+ cell dose <6 × 106/kg.TableEffect of G-CSF on Time to Engraftment, Time to Discharge, Days of Neutropenia and Days of Antibiotic TherapyParameterCSFw/o CSFP ValueMedian day to ANC > 100 (range)11 (8–13)13 (9–15)<0.001Median day to ANC > 50011 (10–14)15 (9–20)<0.001Median day of discharge12 (11–18)15 (12–32)0.0087Days of neutropenia8 (6–15)12 (8–16)<0.001Days of IV antibiotics6 (0–12)8 (0–13)0.03 Open table in a new tab" @default.
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- W2051220026 date "2004-02-01" @default.
- W2051220026 modified "2023-09-27" @default.
- W2051220026 title "Filgrastim (GCSF) is beneficial after autologous peripheral blood grafts with high CD34+ cell content" @default.
- W2051220026 doi "https://doi.org/10.1016/j.bbmt.2003.12.033" @default.
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