Granulocyte colony-stimulating factor following chemotherapy in elderly patients with newly diagnosed acute myelogenous leukemia Journal Article
| Authors: | Maslak, P. G.; Weiss, M. A.; Berman, E.; Yao, T. J.; Tyson, D.; Golde, D. W.; Scheinberg, D. A. |
| Article Title: | Granulocyte colony-stimulating factor following chemotherapy in elderly patients with newly diagnosed acute myelogenous leukemia |
| Abstract: | Given the high treatment-related mortality in elderly patients with acute myelogenous leukemia (AML), we undertook a study using granulocyte colony-stimulating factor (G-CSF) following chemotherapy in an effort to ameliorate toxicity. Patients (> 60 years) received induction with idarubicin 12 mg/m2/day x 3 and cytosine arabinoside (Ara-C) 200 mg/m2/day x 5. A second course of chemotherapy consisting of mitoxantrone 12 mg/m2/day x 3, etoposide (VP-16) 150 mg/m2/day x 3 and Ara-C 200 mg/m2/day x 4 was given approximately 1 month after achieving a complete remission (CR) or immediately if patients failed the first induction. Twenty-four hours following completion of the chemotherapy, G-CSF (10 μg/kg/day continuous i.v. infusion) was started. A historical control group of 28 patients treated without G-CSF was used for comparison. Twenty-six patients were evaluable for response. Following induction, the recovery of neutrophils to greater than 500/μl and 1000/μl was more rapid in the responders who received G-CSF compared to historical controls (median 13 vs 17 days, P = 0.008; 14 vs 19 days, P = 0.005). The toxic death rate of 8% in the study group was significantly lower than the 32% mortality observed in the historical controls (P = 0.04). There was no difference in supportive care requirements or infectious complications. The complete remission (CR) rate was 58% in the entire study group with 71% of de novo AML patients achieving CR. Disease-free survival and overall survival were comparable between the study and historical control groups. These results indicate that G-CSF benefits elderly patients after intensive chemotherapy for AML by decreasing the duration of neutropenia. The reduced neutropenic period may have contributed to the small number of early toxic deaths. |
| Keywords: | clinical article; controlled study; aged; disease-free survival; survival rate; acute granulocytic leukemia; clinical trial; neutropenia; drug efficacy; cytarabine; antineoplastic agent; controlled clinical trial; etoposide; antineoplastic combined chemotherapy protocols; cancer mortality; cytokine; neutrophil; pilot projects; mitoxantrone; remission; remission induction; idarubicin; recombinant granulocyte colony stimulating factor; growth factor; granulocyte colony-stimulating factor; intravenous drug administration; infectious complication; g-csf; aml; leukemia, myelocytic, acute; humans; human; male; female; priority journal; article |
| Journal Title: | Leukemia |
| Volume: | 10 |
| Issue: | 1 |
| ISSN: | 0887-6924 |
| Publisher: | Nature Publishing Group |
| Date Published: | 1996-01-01 |
| Start Page: | 32 |
| End Page: | 39 |
| Language: | English |
| PUBMED: | 8558934 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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