[The efficacy and safety of recombinant human granulocyte colony stimulating factor primed donor peripheral cell harvest in treatment of poor graft function after allogeneic stem cell transplantation].

OBJECTIVE

To assess the efficacy and safety of recombinant human granulocyte colony stimulating factor (rhG-CSF) primed donor peripheral blood stem cell (PBSC) on the treatment of poor graft function (PGF) after allogeneic stem cell transplantation(allo-HSCT).

METHODS

The patients diagnosed as PGF after allo-HSCT and transfused with rhG-CSF primed PBSC from January 2003 to November 2012 were retrospectively analyzed. Hematological response was assessed at day 30 after transfusion. Graft versus host disease (GVHD) was assessed until 6 months after transfusion.

RESULTS

There were 28 patients including 21 men and 7 women with a median age of 28 (12-50) years old. Of these patients, 16 were diagnosed as primary PGF. The median number of transfused mononuclear cells was 2.0 (1.0-5.8)×10(8)/kg. Totally 42.9% (12/28) patients achieved good response. Eight patients (28.6%) developed GVHD. Sixteen patients (57.1%) survived. Age ( ≤ />28 years), gender, donor type (matched sibling/mismatched related), additional conditioning regimen prior to transfusion, time of neutrophil engraftment ( ≤ />18 days) time of transfusion ( ≤ />100 days after allo-HSCT) and number of mononuclear cells ( ≤ />2.0×10(8)/kg) did not impact hematological response. However, response rate of primary PGF(4/16) was significantly lower than that of secondary PGF (8/12) (P = 0.022).

CONCLUSION

Transfusion of PBSC mobilized by rhG-CSF could be considered as an option to treat secondary PGF after allogeneic stem cell transplantation.