G-CSF administered in time-sequenced setting during remission induction and consolidation therapy of adult acute lymphoblastic leukemia has beneficial influence on early recovery and possibly improves long-term outcome: a randomized multicenter study.
Sixty-four untreated adult acute lymphoblastic leukemia (ALL) patients were randomized to receive chemotherapy alone, n = 31 or chemotherapy and granulocyte colony stimulating factor (G-CSF), n = 33. During induction patients received G-CSF for 5 days between four weekly Epirubicin+Vcr administrations, starting 36 h after each application and finishing 48 h before the next one with the intention to possibly generate a cell cycle dependent protection of normal hematopoietic progenitors and to stimulate granulopoiesis. The complete remission (CR) rate equaled 94% in the G-CSF group and 87% in controls. Patients who received G-CSF, if compared to the controls, had shorter granulocytopenia during induction and consolidation, displayed a lower infection rate, completed the induction-consolidation quicker and stayed shorter in hospital during induction, p < 0.001-0.04. Follow-up at 2 years revealed a rather higher probability of survival (59 vs. 27%, p = 0.04) and a lower relapse rate (32 vs. 60%) in G-CSF arm than in controls. The beneficial influence of G-CSF administered in time-sequenced fashion on survival needs further confirmation.
Hołowiecki
Jerzy
J
Department of Haematology and Bone Marrow Transplantation, Silesian Medical Academy, Katowice, Poland. klinhem@infomed.slam.katowice.pl
Giebel
Sebastian
S
Krzemień
Sławomira
S
Krawczyk-Kuliś
Małgorzata
M
Jagoda
Krystyna
K
Kopera
Małgorzata
M
Hołowiecka
Beata
B
Grosicki
Sebastian
S
Hellmann
Andrzej
A
Dmoszyńska
Anna
A
Paluszewska
Monika
M
Robak
Tadeusz
T
Konopka
Lech
L
Maj
Stanisław
S
Wojnar
Jerzy
J
Wojciechowska
Maria
M
Skotnicki
Aleksander
A
Baran
Wojciech
W
Cioch
Maria
M
D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000517:prevention & control; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000633:toxicity; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000633:toxicity; D006801:Humans; D007239:Infections; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012074:Remission Induction / Q000379:methods; D015996:Survival Rate; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor