Title: Favorable effect of priming with granulocyte colony-stimulating factor in remission induction of acute myeloid leukemia restricted to dose escalation of cytarabine
Authors: Pabst, Thomas ×
Vellenga, Edo
van Putten, Wim
Schouten, Harry C
Graux, Carlos
Vekemans, Marie-Christiane
Biemond, Bart
Sonneveld, Peter
Passweg, Jakob
Verdonck, Leo
Legdeur, Marie-Cecile
Theobald, Matthias
Jacky, Emanuel
Bargetzi, Mario
Maertens, Johan
Ossenkoppele, Gert Jan
Löwenberg, Bob
Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON)
German AML Study Group (AMLSG)
Swiss Collaborative Group for Clinical Cancer Research (SAKK)
Verhoef, Gregor #
Issue Date: Jun-2012
Publisher: W.B. Saunders
Series Title: Blood vol:119 issue:23 pages:5367-5373
Article number: 10.1182/blood-2011-11-389841
Abstract: The clinical value of chemotherapy sensitization of acute myeloid leukemia (AML) with G-CSF priming has remained controversial. Cytarabine is a key constituent of remission induction chemotherapy. The effect of G-CSF priming has not been investigated in relationship with variable dose levels of cytarabine. We randomized 917 AML patients to receive G-CSF (456 patients) or no G-CSF (461 patients) at the days of chemotherapy. In the initial part of the study, 406 patients were also randomized between 2 cytarabine regimens comparing conventional-dose (199 patients) versus escalated-dose (207 patients) cytarabine in cycles 1 and 2. We found that patients after induction chemotherapy plus G-CSF had similar overall survival (43% vs 40%, P = .88), event-free survival (37% vs 31%, P = .29), and relapse rates (34% vs 36%, P = .77) at 5 years as those not receiving G-CSF. However, patients treated with the escalated-dose cytarabine regimen benefited from G-CSF priming, with improved event-free survival (P = .01) and overall survival (P = .003), compared with patients without G-CSF undergoing escalated-dose cytarabine treatment. A significant survival advantage of sensitizing AML for chemotherapy with G-CSF was not apparent in the entire study group, but it was seen in patients treated with escalated-dose cytarabine during remission induction. The HOVON-42 study is registered under The Netherlands Trial Registry ( as #NTR230.
ISSN: 0006-4971
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Cell and Gene Therapy Applications (-)
× corresponding author
# (joint) last author

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