Prophylactic use of granulocyte colony-stimulating factor after consolidation therapy with high-dose cytarabine for acute myeloid leukemia

Abstract

Evaluation of: Bradley AM, Deal AM, Buie LW, van Deventer H. Neutropenia-associated outcomes in adults with acute myeloid leukemia receiving cytarabine consolidation chemotherapy with or without granulocyte colony-stimulating factor. Pharmacotherapy 32(12), 1070–1077 (2012).

Prophylactic use of granulocyte colony-stimulating factor after chemotherapy in acute myeloid leukemia patients has become part of the supportive care strategy in some institutions. Despite shortening the neutropenia period and lowering the hospitalization rate, randomized studies have not shown any improvement in the clinical outcomes with this intervention. In their single-institution retrospective study, Bradley et al. reported that granulocyte colony-stimulating factor administration following consolidation therapy with high-dose cytarabine is associated with decreased hospitalization rate and improved survival. This finding is not consistent with the prior knowledge from the randomized studies. Herein, we review some of the explanations for the findings and re-emphasize the limitations of nonrandomized studies in assessing acute myeloid leukemia outcomes, as appreciated by the authors.

Keywords::

• acute myeloid leukemia
• consolidation
• cytarabine
• fever
• granulocyte colony-stimulating factor
• neutropenia
• survival

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.