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Titolo:
GRANULOCYTE-COLONY-STIMULATING FACTOR AS AN ADJUNCT TO INDUCTION CHEMOTHERAPY FOR ADULT ACUTE LYMPHOBLASTIC-LEUKEMIA - A RANDOMIZED PHASE-III STUDY
Autore:
GEISSLER K; KOLLER E; HUBMANN E; NIEDERWIESER D; HINTERBERGER W; GEISSLER D; KYRLE P; KNOBL P; PABINGER I; THALHAMMER R; SCHWARZINGER I; MANNHALTER C; JAEGER U; HEINZ R; LINKESCH W; LECHNER K;
Indirizzi:
AKH WIEN,INNERE MED KLIN 1,ABT HAMATOL & HAMOSTASEOL,WAHRINGER GURTEL18-20 A-1090 VIENNA AUSTRIA UNIV VIENNA,DEPT MED 1,DIV HEMATOL VIENNA AUSTRIA UNIV VIENNA,DEPT LAB MED VIENNA AUSTRIA HANUSCHKRANKENHAUS VIENNA AUSTRIA GRAZ UNIV,DEPT MED,DIV HEMATOL GRAZ AUSTRIA INNSBRUCK UNIV,DEPT MED A-6020 INNSBRUCK AUSTRIA DONAUSPITAL VIENNA AUSTRIA LANDESKRANKENHAUS KLAGENFURT KLAGENFURT AUSTRIA
Titolo Testata:
Blood
fascicolo: 2, volume: 90, anno: 1997,
pagine: 590 - 596
SICI:
0006-4971(1997)90:2<590:GFAAAT>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; FACTOR G-CSF; THERAPY; NEUTROPENIA; TRIAL; MYELOSUPPRESSION; CANCER;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
K. Geissler et al., "GRANULOCYTE-COLONY-STIMULATING FACTOR AS AN ADJUNCT TO INDUCTION CHEMOTHERAPY FOR ADULT ACUTE LYMPHOBLASTIC-LEUKEMIA - A RANDOMIZED PHASE-III STUDY", Blood, 90(2), 1997, pp. 590-596

Abstract

Because of the recommendation to avoid the concomitant administrationof growth factors and chemotherapy, there is only limited informationon colony-stimulating factor (CSF) therapy in acute lymphoblastic leukemia (ALL) induction protocols, in which cytotoxic drugs are administered in divided doses over a prolonged period of time, thus requiring a simultaneous administration of growth factors and chemotherapy. We conducted a prospective, randomized, controlled study to determine the safety and efficacy of granulocyte colony-stimulating factor (G-CSF; filgrastim) as an adjunct to phase I of induction chemotherapy for adult ALL, Patients (n = 53) were randomized to receive no growth factor or G-CSF (5 mu g/kg/d subcutaneously) starting on day 2 of chemotherapyconsisting of daunorubicin (45 mg/m(2)) and vincristine (1.5 mg/m(2))on days 1, 8, 15, and 22; L-asparaginase (2500 U/m(2)) on days 1 through 14; and prednisone (60 mg/m(2)) on days 1 through 28. A total of 25 patients in the G-CSF group and 26 patients in the control arm fulfilled the inclusion criteria of the study. G-CSF markedly ameliorated neutropenia because the median proportion of days with neutropenia lessthan 1,000/mu L was 29% in the G-CSF group as compared with 84% in the control arm (P <.00005). The median time to reach absolute neutrophil counts (ANC) greater than or equal to 1,000/mu L was 16 days in G-CSF patients and 26 days in controls (P <.001). More importantly, G-CSF significantly reduced the incidence of febrile neutropenia (12% v 42% in controls, P <.05) and documented infections (40% v 77%, P <.05). Nosignificant differences were found with regard to requirements for red blood cell transfusions and platelet concentrates. A total of 24 of 25 (96%) patients in the G-CSF group and 20 of 25 (80%) evaluable control patients had complete remission after phase I of induction therapy. We conclude that G-CSF can be safely administered as an adjunct to induction therapy of ALL and is clinically beneficial by ameliorating neutropenia and reducing infectious complications, (C) 1997 by The American Society of Hematology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 01:19:17