Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference?
Background. Despite decades of post–allogeneic hematopoietic cell transplantation (HCT) growth factor utilization, its role remains undefined, leading to ongoing debates and research. The theoretical impacts of growth factors have been challenged in numerous studies. Methods. In this retrospective c...
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Wolters Kluwer
2025-02-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001753 |
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| author | Ahmed Alnughmush, MD Ayman Sayyed, MD Mats Remberger, PhD Eshrak AL-Shaibani, MD Carol Chen, BSc Caden Chiarello Ivan Pasic, MD Igor Novitzky-Basso, MD Arjun Datt Law, MD Wilson Lam, MD Dennis (Dong Hwan) Kim, MD Armin Gerbitz, MD Auro Viswabandya, MD Rajat Kumar, MD Fotios V. Michelis, MD Jonas Mattsson, MD, PhD |
| author_facet | Ahmed Alnughmush, MD Ayman Sayyed, MD Mats Remberger, PhD Eshrak AL-Shaibani, MD Carol Chen, BSc Caden Chiarello Ivan Pasic, MD Igor Novitzky-Basso, MD Arjun Datt Law, MD Wilson Lam, MD Dennis (Dong Hwan) Kim, MD Armin Gerbitz, MD Auro Viswabandya, MD Rajat Kumar, MD Fotios V. Michelis, MD Jonas Mattsson, MD, PhD |
| author_sort | Ahmed Alnughmush, MD |
| collection | DOAJ |
| description | Background. Despite decades of post–allogeneic hematopoietic cell transplantation (HCT) growth factor utilization, its role remains undefined, leading to ongoing debates and research. The theoretical impacts of growth factors have been challenged in numerous studies.
Methods. In this retrospective cohort study conducted at the Princess Margaret Cancer Centre, we analyzed the clinical outcomes of 509 patients who underwent allogeneic HCT between May 1, 2019, and May 31, 2022. This study aimed to assess the impact of granulocyte colony-stimulating factor (G-CSF) administration posttransplantation on neutrophil and platelet engraftment, incidence of bloodstream infections (BSIs), graft-versus-host disease, engraftment syndrome (ES), and survival metrics including overall survival, nonrelapse mortality, and graft-versus-host disease–free/relapse-free survival.
Results. Our findings indicate that G-CSF administration expedited neutrophil engraftment (16 versus 18 d, P = 0.009) and was associated with a decreased incidence of BSI (9.4% versus 31.3%, P = 0.014). However, this benefit was counterbalanced by a significant delay in platelet engraftment (21 versus 17 d, P < 0.001). Multivariate logistic regression analysis identified mismatched donors (odds ratio, 1.72; 95% confidence interval, 1.03-2.88; P = 0.038) and the duration of G-CSF therapy (odds ratio, 1.04; 95% confidence interval, 1.00-1.09; P = 0.038) as independent predictors for the development of ES. Despite these hematological impacts, there was no observed advantage in overall survival, nonrelapse mortality, or graft-versus-host disease–free/relapse-free survival among patients who received G-CSF compared with those who did not.
Conclusions. Although G-CSF post-HCT expedited neutrophil engraftment and reduced BSI risk, it did not result in a survival advantage. The association with ES necessitates careful consideration. |
| format | Article |
| id | doaj-art-dede3662dd8243f9865ac6d0a3127389 |
| institution | Kabale University |
| issn | 2373-8731 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wolters Kluwer |
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| series | Transplantation Direct |
| spelling | doaj-art-dede3662dd8243f9865ac6d0a31273892025-01-24T09:21:00ZengWolters KluwerTransplantation Direct2373-87312025-02-01112e175310.1097/TXD.0000000000001753202502000-00006Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference?Ahmed Alnughmush, MD0Ayman Sayyed, MD1Mats Remberger, PhD2Eshrak AL-Shaibani, MD3Carol Chen, BSc4Caden Chiarello5Ivan Pasic, MD6Igor Novitzky-Basso, MD7Arjun Datt Law, MD8Wilson Lam, MD9Dennis (Dong Hwan) Kim, MD10Armin Gerbitz, MD11Auro Viswabandya, MD12Rajat Kumar, MD13Fotios V. Michelis, MD14Jonas Mattsson, MD, PhD151 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.5 KFUE, Uppsala University Hospital, and IMV, Uppsala University, Uppsala, Sweden.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.2 Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.2 Hans Messner Allogeneic Transplant Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.1 Department of Medicine, University of Toronto, Toronto, ON, Canada.Background. Despite decades of post–allogeneic hematopoietic cell transplantation (HCT) growth factor utilization, its role remains undefined, leading to ongoing debates and research. The theoretical impacts of growth factors have been challenged in numerous studies. Methods. In this retrospective cohort study conducted at the Princess Margaret Cancer Centre, we analyzed the clinical outcomes of 509 patients who underwent allogeneic HCT between May 1, 2019, and May 31, 2022. This study aimed to assess the impact of granulocyte colony-stimulating factor (G-CSF) administration posttransplantation on neutrophil and platelet engraftment, incidence of bloodstream infections (BSIs), graft-versus-host disease, engraftment syndrome (ES), and survival metrics including overall survival, nonrelapse mortality, and graft-versus-host disease–free/relapse-free survival. Results. Our findings indicate that G-CSF administration expedited neutrophil engraftment (16 versus 18 d, P = 0.009) and was associated with a decreased incidence of BSI (9.4% versus 31.3%, P = 0.014). However, this benefit was counterbalanced by a significant delay in platelet engraftment (21 versus 17 d, P < 0.001). Multivariate logistic regression analysis identified mismatched donors (odds ratio, 1.72; 95% confidence interval, 1.03-2.88; P = 0.038) and the duration of G-CSF therapy (odds ratio, 1.04; 95% confidence interval, 1.00-1.09; P = 0.038) as independent predictors for the development of ES. Despite these hematological impacts, there was no observed advantage in overall survival, nonrelapse mortality, or graft-versus-host disease–free/relapse-free survival among patients who received G-CSF compared with those who did not. Conclusions. Although G-CSF post-HCT expedited neutrophil engraftment and reduced BSI risk, it did not result in a survival advantage. The association with ES necessitates careful consideration.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001753 |
| spellingShingle | Ahmed Alnughmush, MD Ayman Sayyed, MD Mats Remberger, PhD Eshrak AL-Shaibani, MD Carol Chen, BSc Caden Chiarello Ivan Pasic, MD Igor Novitzky-Basso, MD Arjun Datt Law, MD Wilson Lam, MD Dennis (Dong Hwan) Kim, MD Armin Gerbitz, MD Auro Viswabandya, MD Rajat Kumar, MD Fotios V. Michelis, MD Jonas Mattsson, MD, PhD Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? Transplantation Direct |
| title | Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? |
| title_full | Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? |
| title_fullStr | Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? |
| title_full_unstemmed | Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? |
| title_short | Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference? |
| title_sort | impact of granulocyte colony stimulating factor g csf on clinical outcomes in allogeneic hematopoietic cell transplantation does speeding up neutrophil engraftment make a difference |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001753 |
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