Use of G-CSF to hasten neutrophil recovery after auto-SCT for AML is not associated with increased relapse incidence: a report from the Acute Leukemia Working Party of the EBMT.
Application of G-CSF in AML is controversial as leukemic blasts may express receptors interacting with the cytokine, which may stimulate leukemia growth. We retrospectively analyzed the impact of G-CSF use to accelerate neutrophil recovery after auto-SCT on outcome. Adults with AML in first CR autografted between 1994 and 2010 were included. Nine hundred and seventy two patients were treated with G-CSF after auto-SCT whereas 1121 were not. BM and PB were used as a source of stem cells in 454 (22%) and 1639 (78%) cases, respectively. The incidence of relapse at 5 years in the BM-auto-SCT group was 38% for patients receiving post-transplant G-CSF and 43% for those not treated with G-CSF, P=0.46. In the PB-auto-SCT cohort, respective probabilities were 48% and 49%, P=0.49. No impact of the use of G-CSF could be demonstrated with respect to the probability of leukemia-free survival: in the BM-auto-SCT group, 51% for G-CSF(+) and 48% for G-CSF(-), P=0.73; in PB-auto-SCT group, 42% for G-CSF(+) and 43% for G-CSF(-), P=0.83. Although G-CSF administration significantly shortened the neutropenic phase, no beneficial effect was observed with regard to non-relapse mortality. In patients with AML, the use of G-CSF after auto-SCT is not associated with increased risk of relapse irrespective of the source of stem cells used.
Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice, Poland.
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Czerw
1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France.
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Labopin
1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France.
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NC
Gorin
Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice, Poland.
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Giebel
Unité de transplantation et de thérapie cellulaire, Institut Paoli-Calmettes, Marseille, France.
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Blaise
Hématologie clinique et Thérapie celllulaire, Hôpital Haut-Lévêque, Pessac, France.
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Dumas
Dipartimento Biotecnologie Cellulari ed Ematologia, Università 'LaSapienza', Rome, Italy.
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Foa
CHU Department Hematologie, Hopital de Purpan, Toulouse, France.
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Attal
Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Schaap
Service Hematologie, Centre Hospitalier Lyon Sud, Lyon, France.
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Michallet
Department of Hematology, Centre Hospitalier Universitaire Brabois, Vandoeuvre les Nancy, France.
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Bonmati
BMT Centre Leiden, Leiden University Hospital, Leiden, The Netherlands.
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Veelken
1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France.
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Mohty
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology / Q000187:drug effects*; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D055815:Young Adult
D016179:Granulocyte Colony-Stimulating Factor