Document Detail


Impact of granulocyte colony-stimulating factor use during induction for acute myelogenous leukemia in children: a report from the Children's Cancer Group.
MedLine Citation:
PMID:  12439034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine whether granulocyte colony-stimulating factor (G-CSF) administered during acute myelogenous leukemia (AML) induction affects hematopoietic and nonhematopoietic toxicity, length and outcome of induction therapy, event-free survival, overall survival, and prognostic significance of the day 7 bone marrow.
PATIENTS AND METHODS: In Children's Cancer Group study 2891, patients were given intensively timed induction with G-CSF (n = 254) after accrual for the regimen without G-CSF (n = 258) was met.
RESULTS: Time to neutropenic recovery after induction courses 1 and 2 was significantly shorter for patients who received G-CSF. Times to platelet recovery were similar regardless of G-CSF use. Effects on incidence of grades 3 and 4 toxicities, infections, or fatal infections were not observed. Use of G-CSF reduced the median length of induction by 9 days and hospital stay by 6 days. Induction remission rates, overall survival, and event-free survival were similar with and without G-CSF. Day 7 bone marrow was prognostic of better long-term outcome. Patients with hypercellular day 7 marrow who received G-CSF had a higher remission rate and event-free survival than patients who did not receive G-CSF.
CONCLUSIONS: The incidence of severe toxic event and infection, induction remission rate, overall survival, and event-free survival were comparable regardless of G-CSF use. Use of G-CSF decreased neutropenia duration, hospital stay, and length of induction. Patients with hypercellular day 7 bone marrow who received G-CSF had an induction remission rate and event-free survival superior to those of patients who did not receive G-CSF.
Authors:
Todd A Alonzo; Nathan L Kobrinsky; Alexander Aledo; Beverly J Lange; Allen B Buxton; William G Woods
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  24     ISSN:  1077-4114     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-19     Completed Date:  2002-12-17     Revised Date:  2011-10-06    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-35     Citation Subset:  IM    
Affiliation:
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. talonzo@childrensoncologygroup.org
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  adverse effects,  therapeutic use*
Bone Marrow / pathology
Child
Cytarabine / administration & dosage
Daunorubicin / administration & dosage
Dexamethasone / administration & dosage
Disease-Free Survival
Etoposide / administration & dosage
Female
Filgrastim / administration & dosage,  adverse effects,  pharmacology*
Follow-Up Studies
Humans
Hyperbilirubinemia / chemically induced
Infection Control
Length of Stay
Leukemia, Myeloid / drug therapy*,  mortality,  pathology
Male
Neutropenia / chemically induced,  prevention & control
Prospective Studies
Remission Induction
Survival Analysis
Thioguanine / administration & dosage
Thrombocytosis / chemically induced,  prevention & control
Treatment Outcome
Chemical
Reg. No./Substance:
121181-53-1/Filgrastim; 147-94-4/Cytarabine; 154-42-7/Thioguanine; 20830-81-3/Daunorubicin; 33419-42-0/Etoposide; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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