Journal article
Human Granulocyte Colony-Stimulating Factor in Children With High-Risk Acute Lymphoblastic Leukemia: A Children’s Cancer Group Study
Journal of clinical oncology, Vol.21(8), pp.1612-1617
04/15/2003
DOI: 10.1200/JCO.2003.07.129
PMID: 12697887
Abstract
Purpose: To investigate the effect of granulocyte colony-stimulating factor (G-CSF) on hematopoietic toxicities, supportive care requirements, time to complete intensive therapy, and event-free survival (EFS) and overall survival (OS) in children with high-risk acute lymphoblastic leukemia (HR-ALL).
Patients and Methods: A total of 287 children with HR-ALL were randomly assigned to intensive chemotherapy regimens (New York I [NY I] or NY II) as part of the Children’s Cancer Group (CCG)-1901 protocol. The induction phases consisted of five drugs (vincristine, prednisone, l-asparaginase, daunorubicin, and cyclophosphamide). Initial consolidation comprised six-agent chemotherapy combined with 18 Gy of total-brain irradiation. Patients were randomly assigned to receive G-CSF (5 μg/kg/day) during either induction or initial consolidation. A crossover study analysis was done on the 259 patients who completed both phases of therapy.
Results: The mean time to neutrophil recovery (≥ 0.5 × 10
9
/L) was reduced with G-CSF (16.7 v 19.1 days, P = .0003); however, patients who received G-CSF did not have significantly reduced episodes of febrile neutropenia (149 v 164, P = .41), positive blood cultures (57 v 61, P = .66), or serious infections (75 v 79, P = .62). Hospitalization (14.0 v 13.9 days, P = .87) and induction therapy completion times (NY I, 30.3 v 31.3 days, P = .11; NY II, 33.4 v 32.3 days, P = .40) were not significantly altered. There were no differences in 6-year EFS (P = .24) or OS (P = .54) between patients receiving or not receiving G-CSF on CCG-1901, NY I and NY II.
Conclusion: Children with high-risk ALL do not appear to benefit from prophylactic G-CSF.
Details
- Title: Subtitle
- Human Granulocyte Colony-Stimulating Factor in Children With High-Risk Acute Lymphoblastic Leukemia: A Children’s Cancer Group Study
- Creators
- John A. HeathPeter G. Steinherz - University of Southern CaliforniaArnold Altman - University of Southern CaliforniaHarland Sather - University of Southern CaliforniaSuresh Jhanwar - University of Southern CaliforniaSteven Halpern - University of Southern CaliforniaRichard Pieters - University of Southern CaliforniaNarayan Shah - University of Southern CaliforniaLaurel Steinherz - University of Southern CaliforniaRaymond Tannous - University of Southern CaliforniaWilliam Terry - University of Southern CaliforniaMichael E. Trigg - University of Southern CaliforniaChildren's Cancer Group
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.21(8), pp.1612-1617
- DOI
- 10.1200/JCO.2003.07.129
- PMID
- 12697887
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 04/15/2003
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984368194402771
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