Myeloid growth factors in acute myeloid leukemia: systematic review of randomized controlled trials
Autor: | Michael A. Morgan, Antonia Zapf, Jürgen Krauter, Arnold Ganser, Michael Heuser |
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Rok vydání: | 2010 |
Předmět: |
Adult
medicine.medical_specialty Neutropenia Myeloid medicine.medical_treatment law.invention Colony-Stimulating Factors Randomized controlled trial law Internal medicine Antineoplastic Combined Chemotherapy Protocols Secondary Prevention medicine Humans Survival rate Randomized Controlled Trials as Topic Chemotherapy Hematology business.industry Remission Induction Myeloid leukemia Bacterial Infections General Medicine Odds ratio Length of Stay medicine.disease Anti-Bacterial Agents Surgery Survival Rate Leukemia Myeloid Acute medicine.anatomical_structure business Febrile neutropenia |
Zdroj: | Annals of Hematology. 90:273-281 |
ISSN: | 1432-0584 0939-5555 |
Popis: | Randomized controlled trials (RCT) investigating administration of colony-stimulating factors (CSF) during or after chemotherapy in acute myeloid leukemia (AML) patients have not been systematically reviewed. We performed a meta-analysis of all reported RCTs comparing prophylactic or concurrent use of CSFs in adult AML patients. Two reviewers extracted data independently. Summary estimates with 95% confidence intervals (CIs) were calculated using a fixed effects model. Fourteen RCTs (n = 4,069 patients) were identified investigating prophylactic CSF administration. Time to neutrophil recovery (>500/μl) was significantly reduced in the CSF group (−4.13 days; 95% CI, −4.23 to −4.04) as was the length of hospitalization (−2.06 days; 95% CI, −2.36 to −1.76). However, no significant reduction in infection-related mortality was observed in CSF-treated compared with control patients (odds ratio (OR) 0.94; 95% CI, 0.8 to 1.1). Prophylactic CSF administration did not impact complete remission (CR) rate or survival. Fourteen RCTs (n = 4,518 patients) were identified investigating administration of CSFs during chemotherapy. Summary estimates of CR, disease/event-free, or overall survival were not significantly different for CSF versus control patients. Prophylactic CSF administration reduces the time to neutrophil recovery and length of hospitalization, but has no impact on documented infections or outcome. Economic analyses of prophylactic CSF administration in AML patients are warranted. |
Databáze: | OpenAIRE |
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