Effects of glycosylated recombinant human granulocyte colony-stimulating factor after high-dose cytarabine-based induction chemotherapy for adult acute myeloid leukaemia
| Autor: | David Gottlieb, Simon Durrant, Jane P. Matthews, Lindsay Dunlop, Paul Cannell, John Bashford, Ray M. Lowenthal, Kerry Taylor, Heather Baxter, Paul Eliadis, Anthony P. Schwarer, Michael F. Leahy, Graham A.R. Young, Douglas E. Joshua, Christopher Arthur, Devinder Gill, A Enno, Timothy A. Brighton, H Januszewicz, A Gillett, Kenneth F. Bradstock |
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| Rok vydání: | 2001 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Glycosylation medicine.medical_treatment Cost-Benefit Analysis Neutropenia Lenograstim Adjuvants Immunologic Internal medicine Granulocyte Colony-Stimulating Factor Medicine Idarubicin Humans Etoposide Chemotherapy business.industry Cytarabine Induction chemotherapy Hematology Middle Aged medicine.disease Recombinant Proteins Granulocyte colony-stimulating factor Survival Rate Leukemia Myeloid Immunology Acute Disease Female business medicine.drug |
| Zdroj: | Leukemia. 15(9) |
| ISSN: | 0887-6924 |
| Popis: | The Australian Leukaemia Study Group (ALSG) investigated whether G-CSF would accelerate haemopoietic recovery after induction treatment for acute myeloid leukaemia (AML) intensified with high-dose cytarabine, and therefore improve response rates and survival. Patients were randomised to receive lenograstim (glycosylated recombinant human G-CSF) 5 microg per kg body weight subcutaneously daily from day 8 after starting chemotherapy, or no cytokine, following chemotherapy with cytarabine 3 g/m2 every 12 h on days 1, 3, 5, and 7, together with idarubicin 9 or 12 mg/m2 on days 1, 2, and 3, plus etoposide 75 mg/m2 on days 1 to 7 inclusive. Patients had untreated AML, and were aged 16 to 60 years. Overall, 54 evaluable patients were randomised to receive lenograstim and 58 to no cytokine. Patients in the lenograstim arm had a significantly shorter duration of neutropenia0.5 x 10(9)/l compared to patients in the no cytokine arm (median 18 vs 22 days; P = 0.0005), and also shorter duration of total leucopenia1.0 x 10(9)/l (17 vs 19 days; P = 0.0002), as well as a reduction in duration of treatment with therapeutic intravenous antibiotics (20 vs 24 days; P= 0.015) and a trend to reduced number of days with fever38.0 degrees C (9 vs 12 days; P = 0.18). There were no differences between the two groups in platelet recovery, red cell or platelet transfusions, or non-haematological toxicities. For patients achieving CR after their first induction course, a reduction in the time to the start of the next course of therapy was observed in the lenograstim arm, from a median of 40.5 days to a median of 36 days (P = 0.082). The overall complete response rates to chemotherapy were similar, 81% in the lenograstim arm vs 75% for the no cytokine arm (P = 0.5), and there was no significant difference in the survival durations. We conclude that the granulopoietic stimulating effect of G-CSF is observed after induction therapy for AML intensified by high-dose cytarabine, resulting in an improvement in a number of clinically important parameters with no major adverse effects. |
| Databáze: | OpenAIRE |
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