1. G-CSF Administered in Time-sequenced Setting During Remission Induction and Consolidation Therapy of Adult Acute Lymphoblastic Leukemia has Beneficial Influence on Early Recovery and Possibly Improves Long-term Outcome: A Randomized Multicenter Study
- Author
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Sławomira Krzemień, Wojciech Baran, Maria Cioch, Aleksander B. Skotnicki, Stanisław Maj, Beata Hołowiecka, Sebastian Giebel, Jerzy Wojnar, Lech Konopka, Małgorzata Kopera, Tadeusz Robak, Małgorzata Krawczyk-Kuliś, Jerzy Holowiecki, Sebastian Grosicki, Anna Dmoszynska, Monika Paluszewska, Krystyna Jagoda, Andrzej Hellmann, and Wojciechowska M
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,acute lymphoblastic leukemia ,G-CSF ,Infections ,Granulopoiesis ,Gastroenterology ,Drug Administration Schedule ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Granulocyte Colony-Stimulating Factor ,cytokine ,medicine ,Humans ,induction ,Survival rate ,Chemotherapy ,business.industry ,Remission Induction ,Hematology ,Length of Stay ,Middle Aged ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Granulocyte colony-stimulating factor ,Surgery ,Survival Rate ,Haematopoiesis ,Treatment Outcome ,Oncology ,Adult Acute Lymphoblastic Leukemia ,Female ,Untreated Adult Acute Lymphoblastic Leukemia ,business ,Agranulocytosis ,Epirubicin ,medicine.drug - Abstract
Sixty-four untreated adult acute lymphoblastic leukemia (ALL) patients were randomized to receive chemotherapy alone, n = 31 or chemotherapy and granulocyte colony stimulating factor (G-CSF), n = 33. During induction patients received G-CSF for 5 days between four weekly Epirubicin+Vcr administrations, starting 36 h after each application and finishing 48 h before the next one with the intention to possibly generate a cell cycle dependent protection of normal hematopoietic progenitors and to stimulate granulopoiesis. The complete remission (CR) rate equaled 94% in the G-CSF group and 87% in controls. Patients who received G-CSF, if compared to the controls, had shorter granulocytopenia during induction and consolidation, displayed a lower infection rate, completed the induction-consolidation quicker and stayed shorter in hospital during induction, p < 0.001-0.04. Follow-up at 2 years revealed a rather higher probability of survival (59 vs. 27%, p = 0.04) and a lower relapse rate (32 vs. 60%) in G-CSF arm than in controls. The beneficial influence of G-CSF administered in time-sequenced fashion on survival needs further confirmation.
- Published
- 2002