Effect of granulocyte colony-stimulating factor on outcomes in patients with non-M3 acute myelogenous leukemia treated with anthracycline-based induction (7+3 regimen) chemotherapies

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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.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalLeukemia Research
Volume57
DOIs
Publication statusPublished - 2017 Jun 1

Fingerprint

Anthracyclines
Granulocyte Colony-Stimulating Factor
Acute Myeloid Leukemia
Drug Therapy
Chemotherapy-Induced Febrile Neutropenia
Febrile Neutropenia
Neutrophils
Therapeutics
Colony-Stimulating Factors
Recurrence
Induction Chemotherapy
Mortality
Incidence
Neutropenia
Multivariate Analysis
Survival

Keywords

  • Acute myelogenous leukemia
  • Granulocyte colony-stimulating factor
  • Neutropenia
  • Treatment-related mortality

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "Effect of granulocyte colony-stimulating factor on outcomes in patients with non-M3 acute myelogenous leukemia treated with anthracycline-based induction (7+3 regimen) chemotherapies",
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.",
keywords = "Acute myelogenous leukemia, Granulocyte colony-stimulating factor, Neutropenia, Treatment-related mortality",
author = "Kang, {Ka Won} and Kim, {Dae Sik} and Lee, {Se Ryeon} and Sung, {Hwa Jung} and Kim, {Seok Jin} and Choi, {Chul Won} and Kim, {Byung Soo} and Yong Park",
year = "2017",
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language = "English",
volume = "57",
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journal = "Leukemia Research",
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T1 - Effect of granulocyte colony-stimulating factor on outcomes in patients with non-M3 acute myelogenous leukemia treated with anthracycline-based induction (7+3 regimen) chemotherapies

AU - Kang, Ka Won

AU - Kim, Dae Sik

AU - Lee, Se Ryeon

AU - Sung, Hwa Jung

AU - Kim, Seok Jin

AU - Choi, Chul Won

AU - Kim, Byung Soo

AU - Park, Yong

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 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.

AB - 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.

KW - Acute myelogenous leukemia

KW - Granulocyte colony-stimulating factor

KW - Neutropenia

KW - Treatment-related mortality

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