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Concomitant Granulocyte Colony-Stimulating Factor and Induction Chemoradiotherapy in Adult Acute Lymphoblastic Leukemia: A Randomized Phase III Trial

Ottmann, Oliver G. ; Hoelzer, Dieter ; Gracien, Edith ; Ganser, Arnold ; Kelly, Krys ; Reutzel, Regina ; Lipp, Thomas ; Busch, Friedrich W. ; Schwonzen, Martin ; Heil, Gerhard ; Wandt, Hannes ; Koch, Peter ; Kolbe, Karin ; Heyll, Axel ; Bentz, Martin ; Peters, Stefan ; Diedrich, Helmut ; Dethling, Jürgen ; Meyer, Peter ; Nowrousian, Mohamed R. ; Löffler, Barbara ; Weiss, Adelheid ; Kneba, Michael ; Föller, Almut ; Graf, Martina ; Hecht, Thomas

Blood, 1995-07, Vol.86 (2), p.444-450 [Periódico revisado por pares]

Washington, DC: Elsevier Inc

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Título:
Concomitant Granulocyte Colony-Stimulating Factor and Induction Chemoradiotherapy in Adult Acute Lymphoblastic Leukemia: A Randomized Phase III Trial
Autor: Ottmann, Oliver G. ; Hoelzer, Dieter ; Gracien, Edith ; Ganser, Arnold ; Kelly, Krys ; Reutzel, Regina ; Lipp, Thomas ; Busch, Friedrich W. ; Schwonzen, Martin ; Heil, Gerhard ; Wandt, Hannes ; Koch, Peter ; Kolbe, Karin ; Heyll, Axel ; Bentz, Martin ; Peters, Stefan ; Diedrich, Helmut ; Dethling, Jürgen ; Meyer, Peter ; Nowrousian, Mohamed R. ; Löffler, Barbara ; Weiss, Adelheid ; Kneba, Michael ; Föller, Almut ; Graf, Martina ; Hecht, Thomas
Assuntos: Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Combined Modality Therapy ; Cranial Irradiation ; Cyclophosphamide - administration & dosage ; Cytarabine - administration & dosage ; Disease-Free Survival ; Female ; Filgrastim ; Granulocyte Colony-Stimulating Factor - therapeutic use ; Hematologic and hematopoietic diseases ; Humans ; Immunologic Factors - therapeutic use ; Infection Control ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Mercaptopurine - administration & dosage ; Methotrexate - administration & dosage ; Middle Aged ; Neutropenia - prevention & control ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Prospective Studies ; Recombinant Proteins - therapeutic use ; Remission Induction ; Survival Analysis ; Treatment Outcome
É parte de: Blood, 1995-07, Vol.86 (2), p.444-450
Descrição: This prospective multicenter study examined whether simultaneous administration of granulocyte colony-stimulating factor (G-CSF; Filgrastim) and induction chemotherapy for adult acute lymphoblastic leukemia (ALL) could prevent treatment-related neutropenia, infections, and resulting treatment delays. Seventy-six patients were randomly assigned to receive either G-CSF (n = 37) or no growth factor (n = 39) in conjunction with a uniform chemotherapy consisting of cyclophosphamide, cytarabine, mercaptopurine, intrathecal methotrexate, and cranial irradiation. The median duration of neutropenia (absolute neutrophil count < 1 × 109/L) during chemotherapy was 8 days in patients receiving G-CSF, compared with 12.5 days in the control group [P < .002). A similar reduction from 11.5 to 7 days was observed in patients with T-ALL receiving additional mediastinal irradiation (P = .13). Infections occurred in 43% and 56% of patients in the G-CSF and control arm, respectively (P = .25); the incidence of nonviral infections was reduced by 50%, from 32 episodes in the control arm to 16 episodes in the G-CSF arm. Prolonged interruptions of chemotherapy administration were less frequent, with delays of 2 weeks or more occurring in only 24% of patients receiving G-CSF as opposed to 46% in the control arm (P = .01). Accordingly, chemotherapy was completed significantly earlier with the use of G-CSF (39 v 44 days, P = .008). With a median follow-up of 20 months, the probability of disease-free survival was 0.45 in the G-CSF group and 0.43 in the control group [P = .34). In conclusion, adult ALL patients appear to benefit by the simultaneous administration of G-CSF with induction chemotherapy because of a significant reduction in the duration of neutropenia, a trend to fewer infections, and a more rapid completion of chemotherapy.
Editor: Washington, DC: Elsevier Inc
Idioma: Inglês

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Concomitant Granulocyte Colony-Stimulating Factor and Induction Chemoradiotherapy in Adult Acute Lymphoblastic Leukemia: A Randomized Phase III Trial

Washington, DC: Elsevier Inc

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