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Periferal kan kök hücre transplantasyonu uygulanan hastalarda destek tedavisinde transplant sonrası +5. günde G-CSF uygulamak avantajlıdır

Applying G-CSF on post-transplant +5th day is advantageous on supportive treatment in patients undergoing peripheral blood stem cell transplantation

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Abstract (2. Language): 
The role of granulocyte-colony stimulating factor (G-CSF) administration on day +5 after peripheral blood stem cell transplantation in terms of hematologic engraftment and supportive treatment need has been evaluated. Forty two consecutive patients with solid and hematological malignancies were enrolled in two groups depending on G-CSF administration. Twenty seven patients were given G-CSF (5 µg/kg/day) from day +5 after the transplantation until the achievement of neutrophil engraftment. Post-transplant GCSF was not given to the control arm of 15 patients. A number of at least 2X10 6 CD34 + cells per kilogram collected by cytapheresis were given to all patients. A significant difference was found between the two groups in favor of G-CSF receiving group, in terms of neutrophil engraftment time (10.55±1.21 vs 11.93±2.89 days; p=0.04), number of days with fever (3.33±2.66 vs 5±2.95 days; p=0.03) and number of days requiring antibiotic therapy (7.07±3.46 vs 11.87±3.74 days; p<0.001), whereas no statistically significant differences were noted in terms of hospitalization period (13.30±4.79 and 13.53±2.56 days; p=0.26), platelet engraftment time (12.22±2.79 and 13.40±3.89 days; p=0.26) and erythrocyte transfusion need; however, platelet transfusion need was statistically significant between the groups with and without G-CSF support (1.27±0.96 vs 0.56±0.75, p=0.01). This study revealed that starting G-CSF on day +5 may fasten the neutrophil engraftment, decrease the number of days with fever and decrease the need for antibiotic therapy in post-transplant period.
Abstract (Original Language): 
Periferik kök hücre naklinden sonra +5. günde granülosit koloni stimüle edici faktör (G-CSF) uygulanmasının hematolojik engraftman ve destek tedavi gereksinimleri açılarından rolü araştırıldı. Solid ve hematolojik maligniteli 42 ardışık hasta G-CSF uygulanmasına göre iki kohort gruba ayrıldı. Yirmi yedi hastaya G-CSF (5 μg/kg/day) nakilden sonraki +5. günden nötrofil engraftmanına kadar verildi. On beş hastadan oluşan kontrol grubuna ise nakil sonrasında GCSF verilmedi. Hastaların hepsine sitaferezle toplanan en az 2X106/kg sayıda CD34+ hücre verildi. Her iki grup arasında, G-CSF alan grup lehine olmak üzere nötrofil engraftman zamanı (10.55±1.21 karşın 11.93±2.89 gün; p=0.04), ateşli gün sayısı (3.33±2.66 karşın 5±2.95 gün; p=0.03) ve antibiyotik tedavisi gerektiren gün sayısı (7.07±3.46 karşın 11.87±3.74 gün; p<0.001) açılarından istatistiksel anlamlı farklılık saptandı; ancak hospitalizasyon süresi (13.30±4.79 ve 13.53±2.56 gün; p=0.26), trombosit engraftman zamanı (12.22±2.79 ve 13.40±3.89 gün; p=0.26) ve eritrosit transfüzyon ihtiyacı bakımından anlamlı farklılık saptanmadı. Trombosit transfüzyon ihtiyacı ise G-CSF desteği yapılan ve yapılmayan gruplar arasında istatistiksel açıdan anlamlı farklı bulundu (1.27±0.96 vs 0.56±0.75, p=0.01). Bu çalışma nakilden sonra +5. günde G-CSF başlanmasının nötrofil engraftmanını hızlandırdığını, ateşli gün sayısını ve antibiyotik ihtiyacını azalttığını göstermektedir.
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