Pegfilgastrim after Allogeneic Transplantation - A Alternative to Daily Filgastrim?.

Long time of aplasie after allogeneic Stem cell- or Bone marrow-transplantation increase the risk of infections complications. Studies showed the positive effect of daily filgastrim to reduce the duration of aplastic time. The use of the Pegfilgastrim promise a simple handle with a single doses after transplantation. Between December 2004 and July 2005 we observed 19 patients with different diseases after SCT or BMT. All patients received a single doses subcutaneous injection of 6 mg pegfilgastrim on day 5 after transplantation. The median leucocytes engraftment was on day 16 after transplantation. The incidence of neutropenic infections was 84 percent with fever unknown origin, 21 percent with catheter induced infections and 10 percent with fungal pneumonia. Side effects of the cytokines had not been observed. The median hospitalisation was 33 days. In compared with the daily doses of Filgastrim 5 mg/kg/day was the duration to leucocytes engraftment and the infections profile similar. The use of the single injection doses of 6 mg pegfilgastrim shows a safe and comfortable profile for patients after allogenic transplantation. Age 17 – 61 years, median 47 years Sex 11 male, 8 female Diseases 8 acute myeloid leukaemia, 1 acute lymphatic leukaemia, 1 chronic myeloid leukaemia, 1 Thalassaemia, 1 non hodgkin lymphoma, 1 osteomyelofibrosis, 5 multiple myeloma, 1 myelodysplastic syndrom Conditioning regime 7 normal conditioning, 12 reduce intensity conditioning Type of transplantation 12 MUD-PBSCT, 5 MMUD-PBSCT, 2 MUD-BMT CD34+ count median 7,9 x 10 6 /kg KG Engraftment of leucocytes median 16 days (10–25 days) Infection disease 16 FUO (84%), 2 fungal-pneumonia (10%), 4 sepsis of catheter (21%) Duration of hospitalisation median 33 days (17 – 47 days)