PF (6 mg fixed dose) is equivalent to daily filgrastim (5 mcg/kg daily for 14 days) after standard dose chemotherapy in decreasing the duration of severe neutropenia. Daily filgrastim (5 mcg/kg) started within 1-4 days after HDC and ASCT leads to significant decrease in time to neutrophil engraftment (NE). The role of PF after HDC and ASCT is not known. We propose to study the role of PF given as a single fixed dose (6 mg) subcutaneoulsy on day ϩ1 after stem cell infusion. Nine patients

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... ng HDC and ASCT using peripheral blood stem cells for multiple myeloma or lymphoma have been enrolled in an ongoing study. Stem cells were collected with peripheral blood pheresis after cyclophosphamide (3 g/sq.m) and daily filgrastim (10 mcg/kg). All patients were eligible for HDC and ASCT as per institutional criteria and signed an informed consent. High dose melphalan (200 mg/sq.m) was used for patients with myeloma. Patients with lymphoma received cyclophosphamide (7200 mg/sq.m), BCNU (400 mg/sq.m) and infusional etoposide (2400 mg/sq.m) as their conditioning regimen. Patients received standard antiinfective prophylaxis per institutional guidelines with acyclovir, levofloxacin and flucanozole starting at day -1. Packed red blood cells (PRBC) were administered for a hematocrit of less than 25%. Platelets were given for a count of less than 20,000 thousand/micro.L. There were no adverse events attributable to PF in these 8 patients. All patients engrafted neutrophils and platelets. There were no deaths on study in patients who received PF. The median time to NE was 10 days (range, 8-11). Incidence of febrile neutropenia was 44% (4/9). Twenty-six bacterial blood cultures were obtained for febrile episodes or a suspected line infection, with only 8 (in 5 patients) being positive, all for coagulase negative staphylococcus. Antibiotics other than for prophylaxis were required in 56% (5/9) of patients. Antifungals other than for prophylaxis were not required in any patient. The median time to platelet engraftment was 17 days (range, 14-19). The median numbers of transfusions were 3 units of PRBC and 12 units of platelets. The median numbers of days with mucositis and total parentral nutrition were 3 (range, 0-9) and 3 (range, 0-12), respectively. Based on this preliminary data, PF at a fixed dose of 6 mg subcutaneoulsy administered on day ϩ1 after HDC and ASCT appears to be equivalent to daily filgrastim.