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Akut miyeloid lösemide indüksiyon ve konsolidasyon tedavisinden sonra rekombinant human granulosit - koloni stimüle edici faktör (rh G-CSF) kullanımı

Recombinant Human Granulocyte-Colony Stimulating Factor (rh G-CSF) After Induction and Consolidation Therapy in Acute Myeloid Leukemia

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 1998

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Neutropenia and subsequent susceptibility to infection are the major side effects of cytotoxic chemotherapy. Although colony stimulating factors have been shown to accelerate recovery from severe neutropenia after intensive chemotherapy, their use in acute leukemia has been controversial because they stimulate leukemic colonies in vitro. To determine the safety and efficacy of recombinant human granulocyte colony-stimulating factor (rh G-CSF), we evaluated 21 periods of rh G-CSF treatment in 15 patients with acute myeloid leukemia (AML) who received induction or consolidation therapy (9 female, 6 male). rh G-CSF (5fi/kg daily subcutaneously) was begun 24 hours after the end of the chemotherapy consisting of Daunorubicin (45 mg/m2 daily intravenously for 3 days) and Ara-C (100 mg/m2 by continuous infusion for 7 days) and continued until the neutrophil count rose above 1000/mm3 for two consecutive days. The historical control group consisted of 19 AML patients who received same chemotherapy regimen but without rh G-CSF. Compared with control group patients treated with rh G-CSF had a significantly faster neutrophil recovery. The number of days to granulocyte recovery above 1000/mm3 was 11+0.81 in the rh G-CSF group versus 20+1.58 days in control group (p<0.001). In conclusion, these results suggest that rh G-CSF as an adjunct to induction and consolidation chemotherapy in AML is safe, accelerating neutrophil recovery after chemotherapy without effecting the regrowth of leukemic cells. [Journal of Turgut Özal Medical Center 1998;5(1):1-6]
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Abstract (Original Language): 
Nötropeni ve yol açtığı enfeksiyona yatkınlık sitotoksik kemoterapinin önde gelen yan etkisidir. Koloni stimüle edici faktörlerin yoğun kemoterapiden sonra gelişen ciddi nötropeninin düzelmesini hızlandırdığı gösterilmiş olmakla birlikte, in vitro olarak lösemik klonları stimüle ettiklerinden akut lösemideki kullanımları tartışmalıdır. Rekombinan human granülosit koloni stimüle edici faktör (rh G-CSF) 'ün emniyetini ve etkinliğini saptamak için indüksiyon ya da konsolidasyon tedavisi alan 15 akut miyeloid lösemi (AML)li hastada (9 kadın, 6 erkek) 21 G-CSF tedavi peryodunu değerlendirdik, rh G-CSF (5mJkg/gün, cilt altı), Daunorubisin (45 mg/m2/gün, 3 gün, intravenöz) ve Ara-C (100 mg/m2/gün, 7 gün, sürekli infüzyon) dan oluşan kemoterapiden 24 saat sonra başlandı ve 2 gün arka arkaya nötrofıl sayısı 1000/mm3 ün üstünde oluncaya kadar devam etti. Daha önceden aynı tedaviyi G-CSF'siz almış olan 19 olgu historik kontrol grubu olarak alındı. Kontrol grubu ile karşılaştırıldığında G-CSF alan hastalarda nötrofıl toparlanma süresi 311+0.81 günken, kontrol grubunda 20+1.58 gündü (p<0.001). Eritrosit sayısı ve trombosit toparlanması üzerine herhangi bir etki saptanmadı. Sonuç olarak, bu bulgular AML de indüksiyon ve konsolidasyon tedavisine eklenen G-CSF'nin, lösemik hücre çoğalmasını etkil emeksiz in nötrofıl toparlanmasını hızlandırması açısından güvenle kullanılabileceğini telkin etmektedir. [Turgut Özal Tıp Merkezi Dergisi 1998;5(1):1-6]
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