***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Introduction Recombinant granulocyte colony-stimulating factor ( G-CSF ) may aid engraftment post high-dose chemo-/radiotherapy in patients with haematological malignancies undergoing allogeneic bone marrow transplantation ( BMT ) ; however , the effects of G-CSF on graft-versus-host disease ( GvHD ) , relapse , and survival are not well defined . Methods In this double-blind , r and omized , placebo-controlled , multicentre , phase 3 study , the effects of the G-CSF Filgrastim on neutrophil and platelet recovery , and on clinical outcomes were evaluated . Patients ( 12–55 years ) receiving an allogeneic BMT for a haematological malignancy were r and omized to receive Filgrastim 5 µg/kg or placebo .  Study treatment was continued until patients achieved an absolute neutrophil count ( ANC ) ≥0.5 × 109/L , or until day 42 . Results Fifty-one patients ( Filgrastim  , N = 25  ; placebo , N = 26 ) were evaluable . Patients treated with Filgrastim had significantly faster engraftment with ANC ≥0.5 × 109/L being achieved after a median ( range ) of 15.0 ( 1.0–22.0 ) days vs. 19.0 ( 15.0–28.0 ) days for placebo ( P < 0.0001 ) . The incidence of GvHD was comparable for both groups . During the limited follow-up ( 2 years ) , Filgrastim had no adverse effect on mortality and possibly reduced the rate of relapse Purpose Pegfilgrastim is a pegylated form of filgrastim , a recombinant protein of granulocyte colony-stimulating factor , that is used to reduce the risk of febrile neutropenia ( FN ) . Here , we report the results of a phase III trial of pegfilgrastim in breast cancer patients receiving docetaxel and cyclophosphamide ( TC ) chemotherapy .  Methods We conducted a double-blind , placebo-controlled , r and omized trial to determine the efficacy of pegfilgrastim in reducing the risk of FN in early-stage breast cancer patients . A total of 351 women ( 177 in the pegfilgrastim group and 174 in the placebo group ) between 20 and 69 years of age with stage I – III invasive breast carcinoma who were to receive TC chemotherapy ( docetaxel 75 mg/m2 and cyclophosphamide 600 mg/m2 every 3 weeks ) as either neoadjuvant or adjuvant therapy were enrolled ; 346 of these patients were treated with either pegfilgrastim ( n = 173 ) or placebo ( n = 173 ) . Results The incidence of FN was significantly lower in the pegfilgrastim group than in the placebo group ( 1.2 vs. 68.8 % , respectively ; P < 0.001 ) . In addition , patients in the pegfilgrastim group required less hospitalization and antibiotics for FN . Most adverse events were consistent with those expected for breast cancer subjects receiving TC chemotherapy . Conclusions Pegfilgrastim is safe and significantly reduces the incidence of FN in breast cancer patients Recombinant human granulocyte colony-stimulating factor ( G-CSF ; filgrastim ) shortens the time to neutrophil recovery after intensive chemotherapy , but its role in the treatment of adults with acute lymphoblastic leukemia ( ALL ) is uncertain . We r and omly assigned 198 adults with untreated ALL ( median age , 35 years ; range , 16 to 83 ) to receive either placebo or G-CSF ( 5 microgram/kg/d ) subcutaneously , beginning 4 days after starting intensive remission induction chemotherapy and continuing until the neutrophil count was > /=1 , 000/microL for 2 days . The study assignment was unblinded as individual patients achieved a complete remission ( CR ) . Patients initially assigned to G-CSF then continued to receive G-CSF through 2 monthly courses of consolidation therapy . Patients assigned to placebo received no further study drug . The median time to recover neutrophils > /=1,000/microL during the remission induction course was 16 days ( interquartile range [ IQR ] , 15 to 18 days ) for the patients assigned to receive G-CSF and 22 days ( IQR , 19 to 29 days ) for the patients assigned to placebo ( P < .001 ) . Patients in the G-CSF group had significantly shorter duration s of neutropenia ( < 1 , 000/microL ) and thrombocytopenia ( < 50,000/microL ) and fewer days in the hospital ( median , 22 days v 28 days ; P = .02 ) compared with patients receiving placebo . The patients assigned to receive G-CSF had a higher CR rate and fewer deaths during remission induction than did those receiving placebo ( P = .04 by the chi-square test for trend ) . During Courses IIA and IIB of consolidation treatment , patients in the G-CSF group had significantly more rapid recovery of neutrophils > /=1,000/microL than did the control group by approximately 6 to 9 days . However , the patients in the G-CSF group did not complete the planned first 3 months of chemotherapy any more rapidly than did the patients in the placebo group . Overall toxicity was not lessened by the use of G-CSF . After a median follow-up of 4 . 7 years , there were no significant differences in either the disease-free survival ( P = .53 ) or the overall survival ( P = .25 ) for the patients assigned to G-CSF ( medians , 2.3 years and 2.4 years , respectively ) compared with those assigned to placebo ( medians , 1.7 and 1.8 years , respectively ) . Adults who received intensive chemotherapy for ALL benefited from G-CSF treatment , but its use did not markedly affect the ultimate outcome Patients with non-myeloid hematologic malignancies ( including Hodgkin 's and non-Hodgkin 's lymphomas , myeloma and acute lymphoid leukemia ) or solid tumors underwent cytoreductive conditioning regimens followed by either autologous bone marrow transplantation ( ABMT ) ( n = 343 ) or transplantation of peripheral blood stem cells ( PBSC ) with ( n = 44 ) or without  bone marrow ( BM ) ( n = 16 ) . In a r and omized double-blind phase III multi-center trial , patients received either granulocyte-macrophage colony-stimulating factor ( GM-CSF , 10 micrograms/kg/day ) or placebo by daily i.v . infusion beginning 24 h after bone marrow infusion and continuing until the absolute neutrophil count ( ANC ) had recovered to > or = 1000/mm3 , or for a maximum of 30 days . Median time to neutrophil recovery was significantly shorter in the GM-CSF group ( 18 vs 27 days , P < 0.001 ) , and more GM-CSF patients had neutrophil recovery by day 30 ( 70 vs 48 % ) . Median duration of hospitalization was significantly shorter in the GM-CSF group ( 29 vs 32 days , P = 0.02 ) . GM-CSF significantly reduced the median time to neutrophil recovery in patients receiving bone marrow only ( 19 vs 27 days , P < 0.001 ) or PBSC with or without bone marrow ( 14 vs 21 days , P < 0.001 ) . The overall incidence of adverse events was comparable in the two groups , although more patients in the GM-CSF group discontinued treatment due to adverse events ( 17 vs 9 % , P < 0.001 ) . No difference was noted in infection incidence or time to platelet independence .  GM-CSF had no negative impact on time to relapse or long-term survival . These data indicate the positive influence of GM-CSF on neutrophil recovery and hospital stay in patients receiving ABMT  for a variety of clinical indications BACKGROUND Neutropenia is common in patients receiving myelotoxic chemotherapy .  Pegfilgrastim , a sustained- duration filgrastim is a once-per-cycle therapy for prophylactic neutrophil support . PATIENTS AND METHODS Women , treated with four cycles of doxorubicin/docetaxel chemotherapy every 21 days , received pegfilgrastim or filgrastim 24 h after chemotherapy as a single subcutaneous injection per chemotherapy cycle ( pegfilgrastim 30 , 60 or 100 microg/kg ) or daily subcutaneous injections ( filgrastim 5 microg/kg/day ) . Safety , efficacy and pharmacokinetics were analyzed . RESULTS The incidence of grade 4 neutropenia in cycle 1 was 95 , 90 and 74 % , in patients who received pegfilgrastim 30 , 60 and 100 microg/kg , respectively , and 76 % in patients who received filgrastim .  Mean duration of grade 4 neutropenia in cycle 1 was 2.7,2 and 1.3 days for doses of pegfilgrastim , and 1.6 days for filgrastim . The pharmacokinetics of pegfilgrastim were non-linear and dependent on both dose and neutrophil count . Pegfilgrastim  serum concentration was sustained until the neutrophil nadir occurred then declined rapidly as neutrophils started to recover , consistent with a self-regulating neutrophil-mediated clearance mechanism . The safety profiles of pegfilgrastim and filgrastim were similar . CONCLUSIONS A single subcutaneous injection of pegfilgrastim 100 microg/kg provided neutrophil support and a safety profile comparable to daily subcutaneous injections of filgrastim during multiple chemotherapy cycles In order to evaluate the potential clinical and economic benefits of granulocyte colony-stimulating factor ( G-CSF , filgrastim ) following peripheral blood progenitor cells ( PBPC ) rescue after high-dose chemotherapy ( HDCT ) , 23 consecutive patients aged less than 60 years with poor-prognosis , high- grade non-Hodgkin 's lymphoma ( NHL ) were entered into a prospect i ve r and omized trial between May 1993 and September 1995 . Patients were r and omized to receive either PBPC alone ( n = 12 ) or PBPC+G-CSF ( n = 11 ) after HDCT with busulphan and cyclophosphamide . G-CSF ( 300 microg day[-1 ] ) was given from day + 5 until recovery of granulocyte count to greater than 1.0 x 10(9 ) l(-1 ) for 2 consecutive days . The mean time to achieve a granulocyte count > 0.5 x 10(9 ) l(-1 ) was significantly shorter in the G-CSF arm ( 9.7 vs 13.2 days ; P<0.0001 ) as was the median duration of hospital stay ( 12 vs 15 days ; P = 0.001 ) . In addition the recovery periods ( range 9 - 12 vs 11 - 17 days to achieve a count of 1.0 x 10(9 ) l[-1 ] ) and hospital stays ( range 11 - 14 vs 13 - 22 days ) were significantly less variable in patients receiving G-CSF in whom the values clustered around the median . There were no statistically significant differences between the study arms in terms of days of fever , documented episodes of bacteraemia , antimicrobial drug usage and platelet/red cell transfusion requirements . Taking into account the costs of total occupied-bed days , drugs , growth factor usage and haematological support , the mean expenditure per inpatient stay was pound sterling 6500 ( range pound sterling 5465-pound sterling 8101 ) in the G-CSF group compared with pound sterling 8316 ( range pound sterling 5953-pound sterling 15,801 ) in the group not receiving G-CSF , with an observed mean saving of 1816 per patient ( or 22 % of the total cost ) in the G-CSF group . This study suggests that after HDCT and PBPC rescue , the use of G-CSF leads to more rapid haematological recovery periods and is associated with a more predictable and shorter hospital stay . Furthermore , and despite the additional costs for G-CSF , these clinical benefits are not translated into increased health care expenditure BACKGROUND Immunological and clinical effects of post-transplant growth factor administration have not been well studied . This report describes the outcome and immune functions of a total of 50 HLA-matched related donor allogeneic blood stem-cell transplantation patients who received post-transplant G-CSF ( 10 microg/kg ) or placebo .  METHODS Immune status , including number of lymphocyte subsets and their functions , and serum immunoglobulin levels and clinical status -- including GvHD , rate of relapse , event-free survival , and overall survival -- were determined in the patients enrolled in this study . RESULTS Twenty-eight patients survived 1 year after transplant , and 15 patients had available results to compare immune function by r and omization assignment . At 12 months post-transplant , immune parameters in G-CSF versus placebo groups showed no statistically significant differences in number of circulating lymphocyte subsets CD3 , CD4 , CD8 , CD19 and CD56 in the two groups . There was no significant ( NS ) difference 
    Output:
    
There was no evidence of a difference in terms of median survival time in the trial comparing GM-CSF and antibiotics .