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

L. Nolan, P. Lorigan, S. Chilton, J. Newman, R. Else, P. Smith, D. Linch, J. W. Sweetenham, P. W. Johnson

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 μg/d), low-dose lenograstim (105 μg/d) or placebo injections. These commenced on day +5 following PBPCR and continued until neutrophil engraftment [absolute neutrophil count (ANC)] ≥ 0.5 × 109/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 × 109/l:10.0 vs. 11.0 d, P = 0.025; ANC ≥ 0.5 × 109/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.

Original languageEnglish (US)
Pages (from-to)436-442
Number of pages7
JournalBritish Journal of Haematology
Volume137
Issue number5
DOIs
StatePublished - Jun 1 2007
Externally publishedYes

Fingerprint

Blood Cells
Neutrophils
Stem Cells
Drug Therapy
Placebos
Survival
Hematopoiesis
Granulocyte Colony-Stimulating Factor
lenograstim
Randomized Controlled Trials
Economics
Anti-Bacterial Agents
Recurrence
Injections
Infection

Keywords

  • CD34
  • Growth factors
  • High-dose therapy
  • Lymphoma
  • Stem cell transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Low-dose lenograstim is as effective as standard dose in shortening neutrophil engraftment time following myeloablative chemotherapy and peripheral blood progenitor cell rescue. / Nolan, L.; Lorigan, P.; Chilton, S.; Newman, J.; Else, R.; Smith, P.; Linch, D.; Sweetenham, J. W.; Johnson, P. W.

In: British Journal of Haematology, Vol. 137, No. 5, 01.06.2007, p. 436-442.

Research output: Contribution to journalArticle

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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 μg/d), low-dose lenograstim (105 μg/d) or placebo injections. These commenced on day +5 following PBPCR and continued until neutrophil engraftment [absolute neutrophil count (ANC)] ≥ 0.5 × 109/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 × 109/l:10.0 vs. 11.0 d, P = 0.025; ANC ≥ 0.5 × 109/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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