Granulocyte Colony Stimulating Factor (G-CSF) After Salvage Chemotherapy in Refractory AML
Status:
Unknown status
Trial end date:
2017-12-01
Target enrollment:
Participant gender:
Summary
Granulocyte Colony Stimulating Factor (G-CSF, filgrastim) is now widely used after
chemotherapy which complicates hematological toxicity involving neutropenia. As prolonged
neutropenia leads to neutropenic fever due to bacteremia or fungal infection, the use of
G-CSF prevents severe infectious complication in various cancer patients.
In acute myeloid leukemia (AML), leukemic blasts have been expected to have G-CSF receptor
which may be stimulated by G-CSF, and refractory patients were not treated with G-CSF in
salvage chemotherapy in Catholic blood and marrow transplantation (BMT) Center for a long
time. This strategy induced prolonged neutropenia and a lot of infectious complications some
of which led to deaths.
Although there are some data which remind us G-CSF may proliferate leukemic blasts, the
investigators also identified several reports which suggested that subgroup with G-CSF use
showed acceptable CR rate and improved survival outcomes compared to a subgroup without G-CSF
use.
Therefore investigators are now trying to identify the effects of G-CSF for refractory AML
patients in salvage chemotherapy setting regarding the duration of neutropenia and admission,
incidence of infectious complications and the duration of antibiotics application.
Furthermore, overall response rate (CR+CRi) after salvage chemotherapy and survival outcomes
will be calculated according to G-CSF use.
Also, investigators will detect G-CSF receptor using cluster of differentiation 114 (CD114),
and analyze the clinical outcomes according to the subgroups with or without using G-CSF
during neutropenic period.