[The potential prognostic influence of granulocyte-colony stimulating factor in acute leukemia]

To investigate the potential influence of granulocyte-colony stimulating factor (G-CSF) on the prognosis of patients with acute leukemia(AL).

In 171 evaluable cases with AL, the complete remission (CR) rate post first course of chemotherapy, CR rate, effective rate, duration of leucopenia post chemotherapy, CR duration, lifespan and the relationship between the dosage of G-CSF and CR duration or lifespan were retrospectively analyzed with Chi-square test, paired t-test, Cox regression, Kaplan-Meier and rank correlation method. For remission induction and postremission therapy, the cases with acute myeloid leukemia (AML) received chemotherapy regimes based on daunorubicin + ara-C (DA), homoharringtonine + ara-C (HA) or mitoxantrone + ara-C (MA). The patients with acute lymphocyte leukemia (ALL) were treated with regimes based on vinblastine + daunorubicin + prednisone (VDP), vinblastine + adriamycin + prednisone (VAP), vinblastine + mitoxantrone + prednisone (VMP) or cyclophosphamide + vinblastine + daunorubicin + prednisone(CODP). In G-CSF group, the patients whose WBC count fell below 1.0 x 10(9)/L after chemotherapy were given rhG-CSF (1.5-6.0 microg.kg(-1).d(-1)) until WBC count restored to 2.5 x 10(9)/L.

(1) Patients administered applied with G-CSF had shorter duration of leucopenia. However, there was no statistical difference between the two groups in the CR rate post first course of chemotherapy, CR rate and the effective rate of treatment. (2) Use of G-CSF did not affect CR durations of ALL patients, but shortened that of AML patients. (3) The application of G-CSF had little effect on the lifespan of ALL patients. By contrast, it showed clearly negative effects on that of AML patients. (4) No relationship between the dosage of G-CSF and CR duration or lifespan in AML patients.

With AML patients, the administration of G-CSF must be very cautious.