The Effect of Granulocyte Colony-Stimulating Factor (G-CSF) on Early Complications and Graft-Versus-Host Disease (GVHD) in Allogeneic Stem Cell Transplantation (ASCT) Recipients

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 9; p. e46105
• Main Authors: Aydın Kaynar, Lale, Özkurt, Zübeyde Nur
• Format: Journal Article
• Language: English
• Published: Palo Alto Cureus Inc 28-09-2023; Cureus
• Subjects: Blood platelets; Cytokines; Disease prevention; Females; Graft versus host disease; Granulocytes; Hematology; Infections; Infectious Disease; Internal Medicine; Leukemia; Lymphoma; Males; Mortality; Multiple myeloma; Neutropenia; Neutrophils; Stem cell transplantation
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.46105

ObjectivesGranulocyte colony-stimulating factor (G-CSF) is commonly used to accelerate neutrophil recovery after allogeneic stem cell transplantation (ASCT) in most transplant centers. There was no consensus on the optimal use of G-CSF after ASCT. Although we use G-CSF to minimize morbidity and mortality, G-CSF can increase the risk of graft-versus-host disease (GVHD). In our study, we want to show the effect of prophylactic G-CSF on infection frequency, neutrophil and platelet engraftment, the duration of neutropenia, the development of GVHD, hospitalization time, and transplant-related mortality (TRM) after ASCT.Materials and methodsOne hundred (71 males and 29 females) patients who did not receive G-CSF and 100 (58 males and 42 females) patients who received prophylactic G-CSF were included in the study.ResultsAge, diagnosis, the time between diagnosis and transplantation, preparation regimen, donor type, and the number of infused cluster of differentiation (CD) 34+ cells were not different in both groups (p>0.05). The frequency of female patients was higher in the group receiving G-CSF. Febrile neutropenia was more frequent in patients who did not receive G-CSF. Neutrophil engraftment and platelet engraftment were detected longer in patients not receiving G-CSF. The frequency of veno-occlusive disease (VOD) and hyperacute, chronic, and acute GVHD was not different in both groups (p>0.05). One hundred-day TRM and five-year overall survival (OS) were similar in the two groups (p>0.05).ConclusionsOur study supports that G-CSF usage does not cause an increase in the frequency of GVHD and has a positive effect on the process by accelerating myeloid engraftment. In light of the data in our study, we can say that the use of G-CSF should be investigated in a randomized controlled clinical trial.