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

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 x 10⁸/kg (4.4, range 1.4-17, vs 2.1, range 0.6-4.2; P <0.0001), mononuclear cells x 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 x 10⁹/l and to platelets > 20 x 10⁹/1 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 x 10⁹/l and to platelets > 20 x 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.