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.
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: ggm1018@gmail.com.
authors.forename: Ka-Won
authors.initials: KW
authors.lastname: Kang
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: kay9801@naver.com.
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: logost@hanmail.net.
authors.forename: Se Ryeon
authors.initials: SR
authors.lastname: Lee
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: doctorsung@korea.ac.kr.
authors.forename: Hwa Jung
authors.initials: HJ
authors.lastname: Sung
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address: seokjin88.kim@samsung.com.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: bonnie@korea.ac.kr.
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: kbs0309@korea.ac.kr.
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Division of Hematology-oncology, Department of Internal Medicine, Korea University School of Medicine, Seoul, South Korea. Electronic address: paark76@hanmail.net.
authors.forename: Yong
authors.initials: Y
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D064146:Chemotherapy-Induced Febrile Neutropenia; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D009026:Mortality; D012074:Remission Induction / Q000379:methods; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D015122:Mercaptopurine; D003630:Daunorubicin
keywords: Acute myelogenous leukemia; Granulocyte colony-stimulating factor; Neutropenia; Treatment-related mortality