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The effect of granulocyte colony-stimulating factors on survival parameters in pediatric patients with acute
Sibel Akpınar Tekgunduz1, Ali Aycicek1, Cengiz Bayram1
1Department of Pediatric Hematology and Oncology, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey.
Insights
Granulocyte colony-stimulating factors (G-CSFs) did not impact relapse-free or overall survival in pediatric acute lymphoblastic leukemia (ALL) patients. This study found no significant difference in outcomes between G-CSF treated and untreated groups.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Pharmacology
Background:
- Limited data exists on granulocyte colony-stimulating factors (G-CSFs) use in pediatric acute lymphoblastic leukemia (ALL).
- G-CSFs are often used to mitigate neutropenia and treatment delays in chemotherapy protocols.
Purpose of the Study:
- To evaluate the impact of G-CSF on relapse-free survival (RFS) and overall survival (OS) in pediatric ALL patients.
- To analyze survival outcomes based on G-CSF administration during treatment.
Main Methods:
- Retrospective analysis of 358 newly diagnosed pediatric ALL patients treated between April 2012 and April 2020.
- Patients were divided into two groups: G-CSF positive (n=245, treated April 2012-December 2016) and G-CSF negative (n=113, treated after December 2016).
- Uniform treatment protocols were applied at a single institution.
Main Results:
- No significant difference in estimated mean relapse-free survival between G-CSF+ (106.5 months) and G-CSF- (82 months) groups (p=0.794).
- Overall survival rates were also similar, with 111.4 months for G-CSF+ and 85 months for G-CSF- groups (p=0.431).
- These findings suggest G-CSF administration did not influence survival outcomes.
Conclusions:
- G-CSF use during the treatment of pediatric ALL did not demonstrate a significant effect on relapse rates.
- Overall survival in pediatric ALL patients was not altered by the administration of G-CSF.
- Further research may be warranted to explore specific subgroups or alternative indications for G-CSF in pediatric ALL.
Objective:
There is a paucity of data concerning the use of granulocyte colony-stimulating factors (G-CSFs) in pediatric patients with acute lymphoblastic leukemia (ALL). The aim of the present study was to evaluate the effect of G-CSF use on relapse-free and overall survival in 358 consecutive, newly diagnosed pediatric ALL patients uniformly treated at the same institution between April 2012 and April 2020.
Materials And Methods:
Patients were evaluated in two separate periods, based on the G-CSF treatment approach. All patients who underwent ALL treatment between April 2012 and December 2016 received G-CSF (G-CSF+ arm; n: 245) in the course of the protocol for reducing the risk of febrile neutropenia and/or inducing neutrophil recovery to prevent any treatment delay. No patients after December 2016 received G-CSF, even if they belonged to the high-risk group, and these were included in the G-CSF- arm (n: 113).
Results:
Estimated mean relapse-free (106.5 months; 95 % CI 102-110.8 vs 82 months 95 % CI 75.2-88.9; p: 0.794) and overall survival (111.4 months; 95 % CI 108-114.8 vs 85 months 95 % CI 80.4-89.8; p: 0.431) rates were similar between the G-CSF+ and G-CSF- groups.
Conclusions:
Our findings indicate that G-CSF use during ALL treatment had no effect on relapse rates or overall survival.
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