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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
Author(s) -
O'Rafferty Ciara,
O'Brien Mairead,
Smyth Elaine,
Keane Sinead,
Robinson Hillary,
Lynam Paul,
O'Marcaigh Aengus,
Smith Owen P.
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12670
Subject(s) - medicine , granulocyte colony stimulating factor , hematopoietic stem cell transplantation , transplantation , hematopoietic cell , haematopoiesis , stem cell , granulocyte , administration (probate law) , immunology , chemotherapy , biology , genetics , political science , law
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.