Abstract
Aims: Autologous peripheral blood stem cell transplantation (PBSCT), performed with high-dose melphalan support following induction therapy is still the gold standard method of treatment for multipl myeloma (MM)patients suitable for transplantation. It was aimed, with this retrospective study, to investigate the effects of early (1 day after PBSCT) and late (5 days after PBSCT) initiation of granulocyte colony-stimulating factor (G-CSF) support following PBSCT on engraftment time, febrile neutropenia, and length of hospital stay (LOS) in MM patients. Methods: This study included 70 patients with MM, who underwent PBSCT in Erciyes University. Two groups were administered 5µg/kg filgrastim, subcutaneously, either 1 day or 5 days after PBSCT, until neutrophil engraftment was reached. Results: Both neutrophil and platelet engraftment occurred in significantly shorter times in the early G-CSF group compared to late G-CSF group; the median times to neutrophil engraftment were 10 (8-13) and 11 (7-15) days, respectively, and the median times to platelet engraftment were 11 (10- 16) and 13 (11- 21) days (p=0.001). Also, the median LOS was also significantly shorter in the early G-CSF group compared to late G-CSF group; 14 (10-22) vs 16 (11- 33) days, respectively (p=0.016). No significant difference was found between the groups in terms of frequency of febrile neutropenia. Conclusion: The initiation of G-CSF support early, following PBSCT in MM patients, accelerated neutrophil and platelet engraftment and shortened the LOS as compared to the initiation of G-CSF support late, with no significant difference in the frequency of febrile neutropenia.
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