Administration of G‐CSF from day +6 post‐allogeneic hematopoietic stem cell transplantation in children and adolescents accelerates neutrophil engraftment but does not appear to have an impact on cost savings

G‐ CSF post‐allogeneic HSCT accelerates neutrophil engraftment, but evidence that it impacts on cost‐related outcomes is lacking. We performed a retrospective child and adolescent single‐center cohort study examining G‐ CSF administration from Day +6 of allogeneic HSCT vs. ad hoc G‐ CSF use where clinically indicated. Forty consecutive children and adolescents undergoing allogeneic HSCT were included. End‐points were as follows: time to engraftment; incidence of acute and chronic GvHD; number of patients alive at Day +100; 180‐day TRM ; post‐transplant days in hospital; and cost of antimicrobials, TPN , and G‐ CSF usage. Neutrophil engraftment occurred earlier in the group that received G‐ CSF from Day +6. There was no difference between groups in any of the other end‐points with the following exception: the cost of GCSF was significantly higher in the D + 6 G‐ CSF group. However, median G‐ CSF cost in this group amounted to only €280. There was a trend towards reduced cost of antimicrobials in the D + 6 G‐ CSF group, although this did not reach significance (p = 0.13). The median cost per patient of antimicrobial agents between groups differed by €1116. This study demonstrated the administration of G‐ CSF on Day +6 in pediatric HSCT to be safe. A further study using a larger cohort of patients is warranted to ascertain its true clinico‐economic value.