G-CSF is routinely administered after autologous bone marrow or peripheral blood progenitor cell transplantation to enhance neutrophil engraftment.
However, many different doses of G-CSF have been described with no clear consensus on the most cost-effective dose.
We performed a prospective randomized trial examining the efficacy of three different doses of G-CSF post-autologous transplant (5,10, or 16 mug/kg/day).
Fifty-seven consecutive patients with breast cancer (n=30), non-Hodgkin's lymphoma (n=16), Hodgkin's disease (n=6), multiple myeloma (n=2), acute leukemia (n=2), and testicular cancer (n=1) were randomized, with 19 patients enrolled in each of the three treatment groups.
All patients underwent a high-dose chemotherapy preparative regimen and received an autologous peripheral blood progenitor cell (PBPC) transplant (without bone marrow), with G-CSF beginning on day 0. There was no difference in time to neutrophil engraftment among the three treatment groups (mean 10.2 to 10.8 days).
There is a trend towards earlier platelet engraftment in the patient group receiving 5 mug/kg/day of G-CSF.
The total cost of G-CSF by dose group was $2900, $4400, and $6500 per patient.
We conclude that there was no advantage to the use of higher doses of G-CSF after autologous transplantation, and that lower doses are associated with lower costs.
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Testicule, Hémopathie maligne, Autogreffe, Greffe, Cellule souche, Cellule hématopoïétique, Sang, Facteur stimulant colonie granulocyte, Traitement, Essai clinique, Randomisation, Dose, Analyse avantage coût, Economie santé, Homme, Glande mammaire pathologie, Transfusion, Testicule pathologie, Appareil génital mâle pathologie, Cytokine, Polypeptide
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Testicle, Malignant hemopathy, Autograft, Graft, Stem cell, Hematopoietic cell, Blood, Granulocyte colony stimulating factor, Treatment, Clinical trial, Randomization, Dose, Cost benefit analysis, Health economy, Human, Mammary gland diseases, Transfusion, Testicular diseases, Male genital diseases, Cytokine, Polypeptide
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0162309
Code Inist : 002B27D02. Création : 21/05/1997.