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Application of recombinant human granulocyte colony stimulating factor in children with acute myeloid leukemia
1Department of Pediatrics, Second Hospital, Beijing Medical University, Beijing 100044, China.
Insights
Recombinant human granulocyte colony stimulating factor (rhG-CSF) significantly accelerates neutrophil recovery in children with acute myeloid leukemia (AML). This treatment reduces the duration of neutropenia and lowers the incidence of fatal infections.
Area of Science:
- Hematology
- Pediatric Oncology
- Pharmacology
Background:
- Childhood acute myeloid leukemia (AML) poses significant treatment challenges.
- Chemotherapy for AML can lead to prolonged neutropenia and increased infection risk.
- Neutrophil recovery is critical for patient outcomes.
Purpose of the Study:
- To assess the efficacy of recombinant human granulocyte colony stimulating factor (rhG-CSF) in pediatric AML.
- To evaluate rhG-CSF's impact on accelerating neutrophil recovery post-chemotherapy.
- To determine if rhG-CSF reduces the incidence of fatal infections in children with AML.
Main Methods:
- A study involving 45 pediatric patients with AML, including 15 newly diagnosed cases.
- Patients received high-dose chemotherapy in combination with rhG-CSF.
- Comparison between rhG-CSF treated groups and control groups was performed.
Main Results:
- Complete remission rates were high (13/15 after one course, 2/15 after two courses) in newly diagnosed patients.
- rhG-CSF significantly shortened the duration of absolute neutrophil counts (ANC) < 0.5 x 10(9)/L by 3-5 days in both newly diagnosed and intensive therapy groups.
- Infection incidence decreased from 60% to 40% in newly diagnosed patients and 44.4% to 25% in intensive therapy patients with rhG-CSF use.
Conclusions:
- rhG-CSF effectively hastens hematopoietic recovery in children with AML.
- The use of rhG-CSF shortens neutropenia duration and reduces fatal infection rates.
- rhG-CSF demonstrated no in vivo stimulation of AML growth.
Objective:
To evaluate the effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) on accelerating neutrophil recovery and decrease fatal infections for childhood acute myeloid leukemia (AML).
Methods:
From November 1992 to March 1997, 45 patients were enrolled into our study and 15 were newly diagnosed. All were treated with high dose chemotherapy combined with rhG-CSF.
Results:
Of 15 newly diagnosed patients, 13 achieved complete remission (CR) after one course of therapy and 2 achieved CR after two courses of therapy. For newly diagnosed patients, the durations of absolute neutrophil counts (ANC) < 0.5 x 10(9)/L were 5 days and 10 days in rhG-CSF group and control group respectively (P < 0.05). The incidences of infection of these two groups were 40% and 60% respectively (P < 0.05). As for patients who received intensive therapy, the durations of ANC < 0.5 x 10(9)/L were 5 days and 8 days in rhG-CSF group and control group, respectively (P < 0.05), and the incidences of infection were 25% and 44.4% respectively (P < 0.05).
Conclusions:
The application of rhG-CSF in children with AML after chemotherapy may hasten the hematopoietic recovery. The duration of neutropenia was shortened by 3-4 days, and the incidence of fatal infection was reduced. rhG-CSF does not stimulate AML growth in vivo.