Granulocyte-stimulating factor and severe aplastic anemia: a survey by the European Group for Blood and Marrow Transplantation (EBMT).
Previous studies suggested a link between the use of G-CSF and increased incidence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) after immunosuppressive therapy (IST) for severe aplastic anemia (SAA). This European survey included 840 patients who received a first-line IST with (43%) or without (57%) G-CSF. The incidences of MDS/AML in patients who did or did not receive G-CSF were 10.9% and 5.8%, respectively. A significantly higher hazard (1.9) of MDS/AML was associated with use of G-CSF. Relapse of aplastic anemia was not associated with a worse outcome in patients who did not receive G-CSF as first therapy, whereas relapse was associated with a significantly worse outcome in those patients who received G-CSF. These results emphasize the necessity of the current European randomized trial comparing IST with or without G-CSF and to alert physicians that adding G-CSF to IST is currently not standard treatment for SAA.
Socie
Gerard
G
Service d'Hématologie Greffe, and Institut National de la Santé et de la Recherche Médicale (INSERM) U728, Hospital Saint Louis, Paris, France. gerard.socie@paris7.jussieu.fr
Mary
Jean-Yves
JY
Schrezenmeier
Hubert
H
Marsh
Judith
J
Bacigalupo
Andrea
A
Locasciulli
Anna
A
Fuehrer
Monica
M
Bekassy
Albert
A
Tichelli
Andre
A
Passweg
Jakob
J
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000188:drug therapy*; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D003625:Data Collection; D005060:Europe; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D011994:Recombinant Proteins; D012307:Risk Factors
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine