The effect of granulocyte colony-stimulating factor dose and administration interval after allogeneic hematopoietic cell transplantation on early engraftment of neutrophil and platelet

• Main Authors: Bonakchi, H. (Author), Hajifathali, A. (Author), Mirfakhraie, R. (Author), Noorazar, L. (Author), Parkhideh, S. (Author), Roshandel, E. (Author), Salimi, M. (Author), Sankanian, G. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: acute lymphoblastic leukemia; acute myeloid leukemia; adult; Adult; allogeneic hematopoietic stem cell transplantation; allograft; Allografts; allo-HSCT; Antigens, CD34; Article; Blood Platelets; busulfan; CD3 antigen; CD3 Complex; CD34 antigen; cell count; cyclophosphamide; donor; dose response; drug dose reduction; drug effect; early engraftment; engraftment; female; Female; fludarabine; granulocyte colony stimulating factor; Granulocyte Colony-Stimulating Factor; health care facility; hematologic disease; Hematologic Neoplasms; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation; human; Humans; Iran; lomustine; major clinical study; male; Male; myeloablative conditioning; neutrophil; Neutrophils; platelet; post-G-CSF; procedures; reduced intensity conditioning; retrospective study; risk factor; Risk Factors; statistical analysis; thrombocyte; thymocyte antibody; time; time factor; Time Factors; Tissue Donors; treatment outcome; Treatment Outcome
• Online Access: View Fulltext in Publisher

 Background: Hematopoietic stem cell transplantation (HSCT) is one of the treatments for hematologic malignancies. Numerous factors affect the HSCT outcome. The purpose of this study was to investigate the effect of post-HSCT administration of granulocyte colony-stimulating factor (post-G-CSF) on early neutrophil and platelet engraftment in allogeneic HSCT (allo-HSCT). Material & methods: The study was performed on 76 patients diagnosed with AML and ALL. All patients underwent allo-HSCT at Taleghani stem cell transplantation center, Tehran, Iran, from February 2016 to December 2018. Chemotherapy regimens based on patients' conditions were selected between myeloablative and reduced-intensity regimens. Results: Statistical analysis revealed that the number of administered G-CSF units after HSCT was a time-dependent variable. Statistical analysis before day +11 reported that patients who received G-CSF <14 units had three times better early neutrophil engraftment than those with G-CSF ≥14 (CI 95%, AHR = 3.03, p:0.002). CD3+ cells count <318.5 × 106/kg was associated with fast platelet engraftment (CI 95%, AHR 2.28, p:0.01). Conclusion: In this study, post-G-CSF stimulation was associated with early engraftment in a time- and dose-dependent manner. Administration of G-CSF beyond 14 units resulted in adverse effects on neutrophil early engraftment. It also appeared that with a reduction in CD3+ cell counts, the likelihood of GVHD decreases, and platelet engraftment occurs earlier. Further investigations in the future are required to determine the factors affecting the process of early engraftment. © 2021 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.