PURPOSE: The primary objective of our meta-analysis was to determine whether prophylactic hematopoietic colony-stimulating factors (CSFs) after hematopoietic autologous and allogeneic stem-cell transplantation (SCT) reduced documented infections. Our secondary objectives were to determine whether prophylactic CSFs affected other outcomes including parenteral antibiotic therapy duration, infection-related mortality, graft-versus-host disease (GVHD), or treatment-related mortality. METHODS: We included studies if there was random assignment between CSFs and placebo/no therapy and CSFs were given after SCT and before recovery of neutrophils. From 3,778 reviewed study articles, 34 were included based on predefined inclusion criteria. All analyses were conducted using a random effects model. RESULTS: CSFs reduced the risk of documented infections (relative risk [RR] 0.87; 95% CI, 0.76 to 1.00; P = .05) and duration of parenteral antibiotics (weighted mean difference, -1.39 days, 95% CI, -2.56 to -0.22; P = .02) but did not reduce infection-related mortality (RR, 0.76; 95% CI, 0.41 to 1.44; P = .4). CSFs did not increase grade 2 to 4 acute GVHD (RR, 1.03; 95% CI, 0.81 to 1.31; P = .8) or treatment-related mortality (RR, 1.00; 95% CI, 0.78 to 1.29; P = .98). CONCLUSION: CSFs were associated with a small reduction in the risk of documented infections but did not affect infection or treatment-related mortality.
PURPOSE: The primary objective of our meta-analysis was to determine whether prophylactic hematopoietic colony-stimulating factors (CSFs) after hematopoietic autologous and allogeneic stem-cell transplantation (SCT) reduced documented infections. Our secondary objectives were to determine whether prophylactic CSFs affected other outcomes including parenteral antibiotic therapy duration, infection-related mortality, graft-versus-host disease (GVHD), or treatment-related mortality. METHODS: We included studies if there was random assignment between CSFs and placebo/no therapy and CSFs were given after SCT and before recovery of neutrophils. From 3,778 reviewed study articles, 34 were included based on predefined inclusion criteria. All analyses were conducted using a random effects model. RESULTS: CSFs reduced the risk of documented infections (relative risk [RR] 0.87; 95% CI, 0.76 to 1.00; P = .05) and duration of parenteral antibiotics (weighted mean difference, -1.39 days, 95% CI, -2.56 to -0.22; P = .02) but did not reduce infection-related mortality (RR, 0.76; 95% CI, 0.41 to 1.44; P = .4). CSFs did not increase grade 2 to 4 acute GVHD (RR, 1.03; 95% CI, 0.81 to 1.31; P = .8) or treatment-related mortality (RR, 1.00; 95% CI, 0.78 to 1.29; P = .98). CONCLUSION: CSFs were associated with a small reduction in the risk of documented infections but did not affect infection or treatment-related mortality.
Authors: Vikas Gupta; Martin S Tallman; Wensheng He; Brent R Logan; Edward Copelan; Robert Peter Gale; Hanna J Khoury; Thomas Klumpp; John Koreth; Hillard M Lazarus; David I Marks; Rodrigo Martino; David A Rizzieri; Jacob M Rowe; Mitchell Sabloff; Edmund K Waller; John F DiPersio; Donald W Bunjes; Daniel J Weisdorf Journal: Blood Date: 2010-06-10 Impact factor: 22.113
Authors: Ningfei An; Michael G Janech; Alison M Bland; John Lazarchick; John M Arthur; Yubin Kang Journal: Exp Hematol Date: 2013-08-27 Impact factor: 3.084
Authors: Marcie Tomblyn; Tom Chiller; Hermann Einsele; Ronald Gress; Kent Sepkowitz; Jan Storek; John R Wingard; Jo-Anne H Young; Michael J Boeckh; Michael A Boeckh Journal: Biol Blood Marrow Transplant Date: 2009-10 Impact factor: 5.742