A randomized, double-blind trial of filgrastim (granulocyte colony-stimulating factor) versus placebo following allogeneic blood stem cell transplantation

• Published in: Blood Vol. 96; no. 1; pp. 80 - 85
• Main Authors: BISHOP, M. R, TARANTOLO, S. R, ARMITAGE, J. O, KESSINGER, A, GELLER, R. B, LYNCH, J. C, BIERMAN, P. J, PAVLETIC, Z. S, VOSE, J. M, KRUSE, S, DIX, S. P, MORRIS, M. E
• Format: Journal Article
• Language: English
• Published: Washington, DC The Americain Society of Hematology 01.07.2000
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Double-Blind Method; Female; Filgrastim; Graft vs Host Disease - prevention & control; Granulocyte Colony-Stimulating Factor - therapeutic use; Hematopoiesis - drug effects; Hematopoietic Stem Cell Transplantation; Humans; Leukemia - blood; Leukemia - mortality; Leukemia - therapy; Leukocyte Count - drug effects; Lymphoma, Non-Hodgkin - blood; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - therapy; Male; Medical sciences; Middle Aged; Multiple Myeloma - blood; Multiple Myeloma - mortality; Multiple Myeloma - therapy; Neutrophils; Placebos; Platelet Count - drug effects; Recombinant Proteins; Survival Rate; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Treatment Outcome; Human; Immunopathology; Acute; Stem cell; Cytokine; Hematopoietic cell; Homograft; Graft versus host reaction; Filgrastim; Blood; Granulocyte colony stimulating factor; Randomization; Treatment; Polypeptide; Double blind study; Graft; Combined treatment
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V96.1.80

Blood stem cell transplantation (BSCT) results in rapid hematopoietic recovery in both the allogeneic and autologous transplant settings. Because of the large numbers of progenitor cells in mobilized blood, the administration of growth factors after transplantation may not provide further acceleration of hematopoietic recovery. A randomized, double-blind, placebo-controlled study was performed to determine the effects of filgrastim (granulocyte colony-stimulating factor; G-CSF) administration on hematopoietic recovery after allogeneic BSCT. Fifty-four patients with hematologic malignancies undergoing a related, HLA-matched allogeneic BSCT were randomly assigned to receive daily filgrastim at 10 microg/kg or placebo starting on the day of transplantation. A minimum of 3 x 10(6) CD34(+) cells/kg in the allograft was required for transplantation. All patients received a standard preparative regimen and a standard regimen for the prevention of graft-versus-host disease (GVHD). The median time to achieve an absolute neutrophil count greater than 0.5 x 10(9)/L was 11 days (range, 9-20 days) for patients who received filgrastim compared with 15 days (range, 10-22 days) for patients who received placebo (P =.0082). The median time to achieve a platelet count greater than 20 x 10(9)/L was 13 days (range, 8-35 days) for patients who received filgrastim compared with 15.5 days (range, 8-42 days) for patients who received placebo (P =.79). There were no significant differences for red blood cell transfusion independence, the incidence of acute GVHD, or 100-day mortality between the groups. The administration of filgrastim appears to be a safe and effective supportive-care measure following allogeneic BSCT.