Efficacy and cost-benefit of filgrastim administered after early assessment bone marrow biopsy during induction therapy for acute myeloid leukemia

Abstract

The role of filgrastim during acute myeloid leukemia (AML) induction therapy remains controversial. At our institution, newly diagnosed AML patients from 2003 through 2019 were retrospectively evaluated. Patients were stratified on whether they received filgrastim within 5 days after early assessment bone marrow (BMBx) and divided into early GCSF group (eGCSF) and no-eGCSF group. A total of 121 patients were included. We found significantly shorter hospital stay (median 24 vs 26 days, p < .01), absolute neutrophil count recovery days (median 23 vs 25 days, p = .03), and intravenous antibiotics days (mean 18.5 vs 21.4 days, p = .01) in patients with eGCSF comparing with no-eGCSF. There was no significant difference regarding complete response rates; however, for those failed to achieve remission, eGCSF was associated with higher blast count. There was no significant difference regarding overall survival or progression-free survival. The use of eGCSF was associated with cost savings of $5199 per patient over no-eGCSF.

Keywords:

• Acute myeloid leukemia
• induction therapy
• filgrastim
• cost-benefit analysis

Disclosure statement

The authors declare no conflicts of interest.

Author contributions

Concept and design: JW, ML, BWC, KB, LM, FO, PF, MG, EM, BG, NKS, BKT. Collection and assembly of data: JW, NKS, BKT. Data analysis of interpretation: JW, NKS, BKT, SC, PF. Manuscript writing: All authors. Final approval of manuscript: All authors.