Kang, Ka-Won; Kim, Dae Sik; Lee, Se Ryeon; Sung, Hwa Jung; Kim, Seok Jin; Choi, Chul Won; Kim, Byung Soo; Park, Yong
Leukemia research
2017Jun ; 57 ( 6 ) :1-8.
PMID : 28231491
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Kang, Ka-Won -
Kim, Dae Sik -
Lee, Se Ryeon -
Sung, Hwa Jung -
Kim, Seok Jin -
Choi, Chul Won -
Kim, Byung Soo -
Park, Yong -
ABSTRACT
We analyzed the effects of granulocyte colony-stimulating factor (G-CSF) on outcomes in 315 anthracycline-based induction chemotherapy-treated patients with non-M3 acute myelogenous leukemia (AML). Patients were classified as follows: no G-CSF administration during induction (no G-CSF group; 112 patients); administration immediately upon neutropenia onset (absolute neutrophil counts (ANC)<1000/μL), but before febrile neutropenia (preemptive group; 74 patients); and administration following febrile neutropenia development (therapeutic group; 129 patients). G-CSF users had a shorter time to ANC recovery than the no G-CSF group (p<0.001). The chemotherapy-induced febrile neutropenia (CIFN) duration was significantly shorter in the preemptive group than in other groups (p<0.001). The incidence of CIFN was not significantly different between preemptive and non-G-CSF users (84.8% versus 82.4%). Preemptive G-CSF administration modestly improved treatment-related mortality (TRM), compared with no G-CSF administration (p=0.076 in multivariate analysis). G-CSF administration did not affect relapse-free or overall survivals or the cumulative relapse incidence among the groups. In conclusion, preemptive G-CSF administration reduced CIFN duration and modestly improved TRM without affecting chemotherapy outcomes. These effects were not observed in the therapeutic group; therefore, initiation of G-CSF during induction therapy before the development of febrile neutropenia may be desirable. CI - Copyright ??2017 Elsevier Ltd. All rights reserved.
Acute myelogenous leukemia; Granulocyte colony-stimulating factor; Neutropenia; Treatment-related mortality
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