Treatment With Granulocyte Colony-Stimulating Factor After Allogeneic Bone Marrow Transplantation for Acute Leukemia Increases the Risk of Graft-Versus-Host Disease and Death: A Study From the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation
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Discussion
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Implication
Randomized trial shows G-CSF increases graft-versus-host disease and mortality in acute leukemia patients, suggesting caution.
Key Points
- To evaluate the effects of granulocyte colony-stimulating factor on outcomes after bone marrow transplantation in acute leukemia.
- Analyzed outcomes of 1,789 patients receiving bone marrow transplantation and 434 receiving peripheral-blood stem cells between 1992 and 2002.
- Compared incidence of graft-versus-host disease and mortality between groups treated with and without G-CSF.
- Utilized a Cox proportional hazards model for analysis.
- G-CSF treatment increased acute graft-versus-host disease (50% vs 39%, RR 1.33, P=0.007).
- Transplantation-related mortality increased (RR 1.73, P=0.00016).
- Survival rates were reduced (RR 0.59, P<0.0001) and leukemia-free survival also decreased (RR 0.64, P=0.0003).
Cite This Study
Ringdén et al. (2003) studied this question.