R. Hawks

Sequential administration of sargramostim and filgrastim in pediatric allogeneic stem cell transplantation recipients undergoing myeloablative conditioning

Abstract: G‐CSF and GM‐CSF both hasten myeloid engraftment post‐MA‐alloSCT; however, GM‐CSF is earlier acting and less expensive. The objective was to evaluate efficacy/safety of sequential administration of GM‐CSF followed by G‐CSF in children post‐MA‐alloSCT. From January 2001 to June 2005, 31 children received 32 MA‐alloSCT: mean age 6.65 yr; MRD BM or PBSC vs. related or unrelated UCB 11:21; malignant vs. non‐malignant disorders 22:10. GM‐CSF (250 μg/m2 IV QD) began on day of stem cell infusion. GM‐CSF was switched to G‐CSF (10 μg/kg IV QD) when WBC ≥ 300/mm3 × 2 days. G‐CSF continued until ANC ≥ 2500/mm3 × 2 days, then tapered to maintain ANC ≥ 1000/mm3. Median time to myeloid engraftment (ANC ≥ 500/mm3 × 3 days) was 17 days [13 days vs. 24 days, MRD BM/PBSC vs. UCB (p < 0.0001)], occurring at a median time of two days after switch to G‐CSF. Clinically relevant adverse events were bone pain (n = 8) and large pleural effusion (n = 1). It was estimated that sequential GM‐CSF/G‐CSF was cost‐effective compared with G‐CSF alone [cost‐savings of

Transplantation-Related Mortality, Graft Failure, and Survival after Reduced-Toxicity Conditioning and Allogeneic Hematopoietic Stem Cell Transplantation in 100 Consecutive Pediatric Recipients

1311/patient (

A Low Incidence of Nontuberculous Mycobacterial Infections in Pediatric Hematopoietic Stem Cell Transplantation Recipients

41,952/study), 2007 Red Book™ Average Wholesale Price]. In summary, it was demonstrated that sequential administration of GM‐CSF/G‐CSF post‐MA‐alloSCT was safe, cost‐effective and resulted in prompt myeloid engraftment.