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Post-Transplant Events

Granulocyte colony-stimulating factor for poor graft function after allogeneic stem cell transplantation: 3 days of G-CSF identifies long-term responders

Bone Marrow Transplantation volume 36, pages 431–435 (2005)Cite this article

Summary:

Poor graft function (PGF) is a frequent cause of morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). To study the value of granulocyte colony-stimulating factor (G-CSF) in PGF, we retrospectively analyzed 81 episodes of PGF in 66 patients transplanted from 01/94 to 01/99 from an HLA-identical sibling (n=45) or an unrelated (n=21) donor. Median age was 29 years, 55 patients had malignancies. A total of 11 patients received a CD34+ selected graft. Viral infections (25%), myelotoxic drug (33%), fungal/bacterial infections (14%), and GVHD (31%) were present before PGF diagnosis. Median time from allo-HSCT to PGF was 75 (25–474) days. All patients were treated with G-CSF. In 77/81 episodes, there was a response that was sustained in 57. A total of 27 patients presented an increase of white cell count (WBC) >0.1 × 109/l after 3 days of G-CSF. The 5-year survival was 37% and was significantly better in patients with increased WBC >0.1 × 109/l after 3 days of G-CSF (65 vs 18%, P<0.0001). In multivariate analysis, increased WBC >0.1 × 109/l after 3 days of G-CSF (P=0.002) was associated with better survival, while BuCy-based conditioning (P=0.02) and GVHD (P=0.005) were associated with higher risk of death. In conclusion, hematological response after 3 days with G-CSF predicted a better survival for patients with PGF after allo-SCT.

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References

  1. Torok-Storb B, Holmberg L, Mielcarek M . Mechanisms of poor marrow function and late graft failure. In: Atkinson K (ed.). Clinical Bone Marrow and Blood Stem Cell Transplantation. Cambridge University Press: Cambridge, 2000, 67–73.

    Google Scholar 

  2. Woolfrey A, Anasetti C . Allogeneic hematopoietic stem-cell engraftment and graft failure. Pediatr Transplant 1999; 3 (Suppl. 1): 35–40.

    Article  PubMed  Google Scholar 

  3. McCann SR, Bacigalupo A, Gluckman E et al. Graft rejection and second bone marrow transplants for acquired aplastic anaemia: a report from the Aplastic Anaemia Working Party of the European Bone Marrow Transplant Group. Bone Marrow Transplant 1994; 13: 233–237.

    CAS  PubMed  Google Scholar 

  4. Gluckman E, Rocha V, Boyer-Chammard A et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group. N Engl J Med 1997; 337: 373–381.

    Article  CAS  PubMed  Google Scholar 

  5. Ash RC, Horowitz MM, Gale RP et al. Bone marrow transplantation from related donors other than HLA-identical siblings: effect of T cell depletion. Bone Marrow Transplant 1991; 7: 443–452.

    CAS  PubMed  Google Scholar 

  6. Georges G, Storb R . Failure of sustained engraftment: clinical manifestations and treatment. In: Atkinson K (ed.). Clinical Bone Marrow and Blood Stem Cell Transplantation. Cambridge Universtity Press: Cambridge, 2000, 662–680.

    Google Scholar 

  7. Bittencourt H, Rocha V, Chevret S et al. Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation. Blood 2002; 99: 2726–2733.

    Article  CAS  PubMed  Google Scholar 

  8. Peralvo J, Bacigalupo A, Pittaluga PA et al. Poor graft function associated with graft-versus-host disease after allogeneic marrow transplantation. Bone Marrow Transplant 1987; 2: 279–285.

    CAS  PubMed  Google Scholar 

  9. Salzberger B, Bowden RA, Hackman RC et al. Neutropenia in allogeneic marrow transplant recipients receiving ganciclovir for prevention of cytomegalovirus disease: risk factors and outcome. Blood 1997; 90: 2502–2508.

    CAS  PubMed  Google Scholar 

  10. Torok-Storb B, Boeckh M, Hoy C et al. Association of specific cytomegalovirus genotypes with death from myelosuppression after marrow transplantation. Blood 1997; 90: 2097–2102.

    CAS  PubMed  Google Scholar 

  11. Sierra J, Terol MJ, Urbano-Ispizua A et al. Different response to recombinant human granulocyte-macrophage colony-stimulating factor in primary and secondary graft failure after bone marrow transplantation. Exp Hematol 1994; 22: 566–572.

    CAS  PubMed  Google Scholar 

  12. Glucksberg H, Storb R, Fefer A et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation 1974; 18: 295–304.

    Article  CAS  PubMed  Google Scholar 

  13. Shulman HM, Sullivan KM, Weiden PL et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med 1980; 69: 204–217.

    CAS  PubMed  Google Scholar 

  14. Ozer H, Armitage JO, Bennett CL et al. 2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. American Society of Clinical Oncology Growth Factors Expert Panel. J Clin Oncol 2000; 18: 3558–3585.

    Article  CAS  PubMed  Google Scholar 

  15. Nemunaitis J, Singer JW, Buckner CD et al. Use of recombinant human granulocyte-macrophage colony-stimulating factor in graft failure after bone marrow transplantation. Blood 1990; 76: 245–253.

    CAS  PubMed  Google Scholar 

  16. Weisdorf DJ, Verfaillie CM, Davies SM et al. Hematopoietic growth factors for graft failure after bone marrow transplantation: a randomized trial of granulocyte-macrophage colony-stimulating factor (GM-CSF) versus sequential GM-CSF plus granulocyte-CSF. Blood 1995; 85: 3452–3456.

    CAS  PubMed  Google Scholar 

  17. Bruno B, Gooley T, Sullivan KM et al. Secondary failure of platelet recovery after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2001; 7: 154–162.

    Article  CAS  PubMed  Google Scholar 

  18. Storb R, Prentice RL, Buckner CD et al. Graft-versus-host disease and survival in patients with aplastic anemia treated by marrow grafts from HLA-identical siblings. Beneficial effect of a protective environment. N Engl J Med 1983; 308: 302–307.

    Article  CAS  PubMed  Google Scholar 

  19. Greenberger JS . Toxic effects on the hematopoietic microenvironment. Exp Hematol 1991; 19: 1101–1109.

    CAS  PubMed  Google Scholar 

  20. Niederwieser D, Pepe M, Storb R et al. Improvement in rejection, engraftment rate and survival without increase in graft-versus-host disease by high marrow cell dose in patients transplanted for aplastic anaemia. Br J Haematol 1988; 69: 23–28.

    Article  CAS  PubMed  Google Scholar 

  21. Rocha V, Labopin M, Gluckman E et al. Relevance of bone marrow cell dose on allogeneic transplantation outcomes for patients with acute myeloid leukemia in first complete remission: results of a European survey. J Clin Oncol 2002; 20: 4324–4330.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Claudio Brunstein for language assistance early on this manuscript. The Association de Recherche sur les Transplantations Médullaire (ARTM) supported HB, VR, and FG.

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Authors and Affiliations

  1. Bone Marrow Transplant Unit, Hospital Saint-Louis, Paris, France

    H Bittencourt, V Rocha, A Filion, I Ionescu, A-L Herr, F Garnier, L Ades, H Esperou, A Devergie, P Ribaud, G Socie & E Gluckman

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  1. H Bittencourt
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  2. V Rocha
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Correspondence to E Gluckman.

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Bittencourt, H., Rocha, V., Filion, A. et al. Granulocyte colony-stimulating factor for poor graft function after allogeneic stem cell transplantation: 3 days of G-CSF identifies long-term responders. Bone Marrow Transplant 36, 431–435 (2005). https://doi.org/10.1038/sj.bmt.1705072

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