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KMID : 0191120000150010049
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Journal of Korean Medical Science
2000 Volume.15 No. 1 p.49 ~ p.52
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The possible cost effectiveness of peripheral blood stem cell mobilization with cyclophosphamide and the late addition of G-CSF
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Min YJ
Kim SW/Suh C/Park J/Kim HJ/Kim JG/Kim TW/Lee JH/Kim SB/Lee KH/Lee JS/Kim WK/Kim SH
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Abstract
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The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 μg dose of G-CSF (Neutrogen®) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 106/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses ≥ 2.0 x 106/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils ≥ 0.5 x 109/L or platelets < 20 x 109/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p<0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.
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