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Low-dose lenograstim is as effective as standard dose in shortening neutrophil engraftment time following myeloablative chemotherapy and peripheral blood progenitor cell rescue

Low-dose lenograstim is as effective as standard dose in shortening neutrophil engraftment time following myeloablative chemotherapy and peripheral blood progenitor cell rescue
Low-dose lenograstim is as effective as standard dose in shortening neutrophil engraftment time following myeloablative chemotherapy and peripheral blood progenitor cell rescue
Granulocyte colony-stimulating factor (G-CSF) is widely used following myeloablative chemotherapy (high-dose therapy; HDT) and peripheral blood progenitor cell rescue (PBPCR) to reduce neutrophil engraftment time. The dose and duration required to gain maximum clinical and economic benefit has not been fully investigated. This double blind placebo-controlled randomised trial was performed to determine whether short course low-dose or standard-dose Lenograstim (L) would influence recovery of haematopoiesis following HDT and PBPCR. Sixty-one patients were randomised between May 1999 and November 2004, to receive standard-dose lenograstim (263 mu g/d), low-dose lenograstim (105 mu g/d) or placebo injections. These commenced on day +5 following PBPCR and continued until neutrophil engraftment [absolute neutrophil count (ANC)] >= 0.5 x 10(9)/l. Patients received standard supportive care until haemopoietic recovery. Both standard- and low-dose lenograstim resulted in a significantly shorter median time to neutrophil recovery (ANC >= 0.1 x 10(9)/l:10.0 vs. 11.0 d, P = 0.025; ANC >= 0.5 x 10(9)/l:11.0 vs. 14.0 d, P = 0.0002) compared with placebo. There was no significant difference in blood product support, antibiotic usage, documented infection, overall survival or relapse-free survival between the groups. Short course low-dose lenograstim is as effective as standard-dose in reducing neutrophil engraftment time following HDT and PBPCR.
g-csf, cell, patient, rescue, infection, recovery, bone-marrow transplantation, growth-factors, growth factors, benefit, lymphoma patients, trial, supportive care, chemotherapy, high-dose therapy, therapy, stem-cell, cd34, lymphoma, colony-stimulating factor, prospective randomized-trial, time, survival, double-blind, stem cell transplantation
0007-1048
436-442
Nolan, L.
b93be062-e519-4677-a708-a0d2c26acd24
Lorigan, P.
42f0a90b-b129-4d62-aa8a-0463046f563b
Chilton, S.
31f49fce-0253-4a01-a0ef-5df4a6880279
Newman, J.
373626fe-b2c7-40ee-a850-1c5f605d2fb4
Else, R.
74d384f8-1808-48ad-a088-da89d79f0d86
Smith, P.
11f678ab-4aee-426a-aedd-19719d80bbbc
Linch, D.
44bd0701-104b-4b31-9239-f8f93e436109
Sweetenham, J.W.
4ea41ea4-f6aa-43c2-bb4c-804832d980e5
Johnson, P.W.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f
Nolan, L.
b93be062-e519-4677-a708-a0d2c26acd24
Lorigan, P.
42f0a90b-b129-4d62-aa8a-0463046f563b
Chilton, S.
31f49fce-0253-4a01-a0ef-5df4a6880279
Newman, J.
373626fe-b2c7-40ee-a850-1c5f605d2fb4
Else, R.
74d384f8-1808-48ad-a088-da89d79f0d86
Smith, P.
11f678ab-4aee-426a-aedd-19719d80bbbc
Linch, D.
44bd0701-104b-4b31-9239-f8f93e436109
Sweetenham, J.W.
4ea41ea4-f6aa-43c2-bb4c-804832d980e5
Johnson, P.W.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f

Nolan, L., Lorigan, P., Chilton, S., Newman, J., Else, R., Smith, P., Linch, D., Sweetenham, J.W. and Johnson, P.W. (2007) Low-dose lenograstim is as effective as standard dose in shortening neutrophil engraftment time following myeloablative chemotherapy and peripheral blood progenitor cell rescue. British Journal of Haematology, 137 (5), 436-442. (doi:10.1111/j.1365-2141.2007.06587.x).

Record type: Article

Abstract

Granulocyte colony-stimulating factor (G-CSF) is widely used following myeloablative chemotherapy (high-dose therapy; HDT) and peripheral blood progenitor cell rescue (PBPCR) to reduce neutrophil engraftment time. The dose and duration required to gain maximum clinical and economic benefit has not been fully investigated. This double blind placebo-controlled randomised trial was performed to determine whether short course low-dose or standard-dose Lenograstim (L) would influence recovery of haematopoiesis following HDT and PBPCR. Sixty-one patients were randomised between May 1999 and November 2004, to receive standard-dose lenograstim (263 mu g/d), low-dose lenograstim (105 mu g/d) or placebo injections. These commenced on day +5 following PBPCR and continued until neutrophil engraftment [absolute neutrophil count (ANC)] >= 0.5 x 10(9)/l. Patients received standard supportive care until haemopoietic recovery. Both standard- and low-dose lenograstim resulted in a significantly shorter median time to neutrophil recovery (ANC >= 0.1 x 10(9)/l:10.0 vs. 11.0 d, P = 0.025; ANC >= 0.5 x 10(9)/l:11.0 vs. 14.0 d, P = 0.0002) compared with placebo. There was no significant difference in blood product support, antibiotic usage, documented infection, overall survival or relapse-free survival between the groups. Short course low-dose lenograstim is as effective as standard-dose in reducing neutrophil engraftment time following HDT and PBPCR.

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More information

Published date: 2007
Keywords: g-csf, cell, patient, rescue, infection, recovery, bone-marrow transplantation, growth-factors, growth factors, benefit, lymphoma patients, trial, supportive care, chemotherapy, high-dose therapy, therapy, stem-cell, cd34, lymphoma, colony-stimulating factor, prospective randomized-trial, time, survival, double-blind, stem cell transplantation

Identifiers

Local EPrints ID: 62867
URI: http://eprints.soton.ac.uk/id/eprint/62867
ISSN: 0007-1048
PURE UUID: 3292ecd2-a512-41f7-97b7-e0ef6d526535
ORCID for P.W. Johnson: ORCID iD orcid.org/0000-0003-2306-4974

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Date deposited: 11 Sep 2008
Last modified: 16 Mar 2024 02:59

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Contributors

Author: L. Nolan
Author: P. Lorigan
Author: S. Chilton
Author: J. Newman
Author: R. Else
Author: P. Smith
Author: D. Linch
Author: J.W. Sweetenham
Author: P.W. Johnson ORCID iD

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