Revisiting G-CSF Support for Hematologic Recovery after Autologous Transplantation in AML Patients

Oberson, JS; Novak, Urban; Mansouri Taleghani, Behrouz; Baerlocher, Gabriela M.; Seipel, Katja; Mueller, BU; Leibundgut, Kurt; Zimmerli, Stefan; Pabst, Thomas (2017). Revisiting G-CSF Support for Hematologic Recovery after Autologous Transplantation in AML Patients. Annals of Hematology & Oncology, 4(5), p. 1148. Austin Publishing Group 10.26420/annhematoloncol.2017.1148

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In acute myeloid leukemia (AML) patients, using granulocyte colony-stimulating factor (G-CSF) to support hematologic recovery in induction and consolidation treatment reduces the number of febrile episodes and the duration of neutropenia and hospitalization. However, the benefit and safety of administering G-CSF to enhance hematologic recovery in AML patients after autologous stem cell transplantation (ASCT) have not been reported so far. At our center, it was our policy to administer G-CSF after ASCT in all AML patients. In June 2015, increasing economic pressure prompted us to omit G-CSF after ASCT. In this retrospective study, we assessed the effects of changing our strategy from applying G-CSF for hematologic recovery after ASCT (in 103 AML patients) to omitting G-CSF (12 patients). We found that administering G-CSF shortened the median duration until neutrophil recovery was >0.5 G/l after ASCT by four days (P=.0001), and patients with G-CSF tended to have fewer bacteremias (38.3% versus 66.6%; P=.0654). The median duration of hospitalization was two days longer in patients without G-CSF support (25 versus 23 days; P=.0603). According to the Swiss in-patient reimbursement system, the shorter hospitalization of +G-CSF patients resulted in decreased total costs per patient of 3305 CHF (48 Mio U of G-CSF), and 3367 CHF (30 Mio U). Finally, no differences were observed in disease free (P=.0938) and overall survival (P=.7999) rates between +G-CSF versus –G-CSF patients. Our data suggest that G-CSF support after ASCT is safe and associated with shorter time until neutrophil recovery, fewer bacteremia episodes, shorter hospitalization, and lower costs. Keywords: Autologous; Transplant; AML; Leukemia; Recovery; Prognosis; Survival; Granulocyte-colony Stimulating factor; G-CSF; Consolidation

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Novak, Urban; Mansouri Taleghani, Behrouz; Baerlocher, Gabriela M.; Seipel, Katja; Leibundgut, Kurt; Zimmerli, Stefan and Pabst, Thomas

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

2375-7965

Publisher:

Austin Publishing Group

Language:

English

Submitter:

Nicole Corminboeuf

Date Deposited:

22 Feb 2018 15:22

Last Modified:

22 Feb 2018 15:22

Publisher DOI:

10.26420/annhematoloncol.2017.1148

BORIS DOI:

10.7892/boris.111454

URI:

https://boris.unibe.ch/id/eprint/111454

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