BioChem - DOS

Effectiveness and safety of granulocyte colony-stimulating factor priming regimen for acute myeloid leukemia: A systematic review and meta-analysis of the Clinical Practice Guideline for the use of G-CSF 2022 from the Japan Society of Clinical Oncology

International journal of clinical oncology

Najima, Yuho; Maeda, Tomoya; Kamiyama, Yutaro; Nakao, Shinji; Ozaki, Yukinori; Nishio, Hiroshi; Tsuchihashi, Kenji; Ichihara, Eiki; Miumra, Yuji; Endo, Makoto; Maruyama, Dai; Yoshinami, Tetsuhiro; Susumu, Nobuyuki; Takekuma, Munetaka; Motohashi, Takashi; Ito, Mamoru; Baba, Eishi; Ochi, Nobuaki; Kubo, Toshio; Uchino, Keita; Kimura, Takahiro; Tamura, Shinobu; Nishimoto, Hitomi; Kato, Yasuhisa; Sato, Atsushi; Takano, Toshimi; Yano, Shingo

BACKGROUND: The outcomes of relapsed or refractory acute myeloid leukemia (AML) remain poor. Although the concomitant use of granulocyte colony-stimulating factor (G-CSF) and anti-chemotherapeutic agents has been investigated to improve the antileukemic effect on AML, its usefulness remains controversial. This study aimed to investigate the effects of G-CSF priming as a remission induction therapy or salvage chemotherapy. METHODS: We performed a thorough literature search for studies related to the priming effect of G-CSF using PubMed, Ichushi-Web, and the Cochrane Library. A qualitative analysis of the pooled data was performed, and risk ratios (RRs) with confidence intervals (CIs) were calculated and summarized. RESULTS: Two reviewers independently extracted and accessed the 278 records identified during the initial screening, and 62 full-text articles were assessed for eligibility in second screening. Eleven studies were included in the qualitative analysis and 10 in the meta-analysis. A systematic review revealed that priming with G-CSF did not correlate with an improvement in response rate and overall survival (OS). The result of the meta-analysis revealed the tendency for lower relapse rate in the G-CSF priming groups without inter-study heterogeneity [RR, 0.91 (95% CI 0.82-1.01), p = 0.08; I2 = 4%, p = 0.35]. In specific populations, including patients with intermediate cytogenetic risk and those receiving high-dose cytarabine, the G-CSF priming regimen prolonged OS. CONCLUSIONS: G-CSF priming in combination with intensive remission induction treatment is not universally effective in patients with AML. Further studies are required to identify the patient cohort for which G-CSF priming is recommended.

2024

Springer-Verlag

1341-9625

1437-7772

29

7

pp.899-910

10.1007/s10147-023-02461-4

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