[Influence of hematopoietic growth factors on transfusion support following autologous bone marrow transplantation].

PURPOSE

To determine the effect of haematopoietic growth factors (HGFs) (G-CSF and GM-CSF) on supporting platelet and red blood cell (RBC) transfusions in patients undergoing autologous bone marrow transplantation.

PATIENTS AND METHODS

We retrospectively evaluated the transfusion requirements of 44 patients over three months post-transplant. Ten of these patients received recombinant human G-CSF and ten received GM-CSF. This group was compared with the control group, formed of 24 patients who did not received HGFs. The patients receiving HGFs did not differ significantly from those who did not receive growth factor with regard to age, sex, diagnosis, number of bone marrow cells infused and clinical factors affecting the efficacy of platelet and/or RBC transfusion (fever, infection, amphotericin B treatment, bleeding episodes). Statistical analysis of the results was made using the Mann-Whitney U test, with a p value significant at the 0.05 level.

RESULTS

No significant effect of HGFs on platelet cell recovery was observed, but there was a trend for the time taken to recovery to increase. The median time of duration of platelet support dependence in the HGFs treated group was 19 days (range 7-100), compared with 15 days (range 3-65) in the control group. The number of platelet transfusions was 8.5 (2-43) and 7.5 (1-33) respectively. The treated patients received a median of 57 units of platelets (range 12-363), compared with 49 in the controls (range 7-206). In NHL there was a reduced need for platelet transfusions in HGFs group. In HD, HGFs increased platelet usage considerably (p < 0.05), although these groups were formed by only 5 and 7 patients respectively. The median RBC usage was the same between both patient groups (6 units of packed red cells).

CONCLUSION

In our patients, the administration of HGFs has no beneficial effect on blood product requirements.