Autologous bone marrow transplantation in non-Hodgkin’s lymphoma patients: effect of a brief course of G-CSF on harvest and recovery

Abstract

This study compares harvest and hematological recovery data of 100 lymphoma patients who underwent BM harvest either after a short course of G-CSF (16 μg/kg for 3 days) (n = 57) or in steady-state conditions (n = 43). G-CSF allowed the attainment of a significantly higher median number of total nucleated cells × 10⁸/kg (4.4, range 1.4–17, vs 2.1, range 0.6–4.2; P < 0.0001), mononuclear cells × 10⁸/kg (0.55, range 0.20–1.4, vs 0.41, range 0.15–0.76, P < 0.0001) and cfu-gm/ml (310, range 10–5500, vs 80, range 10–3800, P = 0.008), with lower volumes of blood collected (17.5 ml/kg, range 8–31 vs 21.0, range 15–30, P = 0.0001). Hematological recovery was faster in patients who received pre-treated BM (median time to PMN >0.5 × 10⁹/l and to platelets >20 × 10⁹/l was 12, range 10–14, and 13, range 10–18, days, respectively) than in those autotransplanted with steady-state BM (median time to PMN >0.5 × 10⁹/l and to platelets >20 × 10⁹/l 13, range 10–18 and 14, range 10–20 days, respectively, P = 0.004 and P = 0.01). Transfusional requirement was significantly different and patients of the G-CSF group needed shorter hospitalization (17 days, range 12–24, vs 20 days, range 14–32; P = 0.02). These data suggest that treating patients with G-CSF before BM harvest improves the quality of the harvest and accelerates engraftment and hematological recovery.