Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia
Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia
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DOI：
10.1038/bcj.2017.45
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发表时间：
2017-05-01
影响因子：
12.8
通讯作者：
Schlenk, R. F.
中科院分区：
文献类型：
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作者：
Jaramillo, S.;Benner, A.;Schlenk, R. F.
本队列研究的目的是比较第1、2和3天（HDAC-123）高剂量阿糖胞苷巩固治疗的浓缩方案与第1、3和5天（HDAC-135）给予的HDAC方案，以及评价首次完全缓解的年轻急性髓性白血病患者化疗后预防性使用培非格司亭。在AMLSG 07-04和德国AML Intergroup方案中，分别有176例患者在第10天和第8天接受HDAC-135和392例患者接受HDAC-123预防性培非格司亭治疗。接受HDAC-123治疗的患者从开始化疗到血液学恢复（白色细胞> 1.0 G/l和中性粒细胞> 0.5 G/l）的时间比接受HDAC-135治疗的患者中位时间短4天（均P <0.0001），培非格司亭进一步缩短2天（P < 0.0001）。HDAC-123（P < 0.0001）和培非格司亭（P = 0.002）降低了感染率。与HDAC-135相比，HDAC-123显著减少了住院天数和血小板输注。HDAC-123与HDAC-135和培非格司亭均不影响生存率。总之，HDAC-123的巩固治疗导致更快的血液学恢复和更少的感染、血小板输注以及住院天数，而不影响生存。
The aim of this cohort study was to compare a condensed schedule of consolidation therapy with high-dose cytarabine on days 1, 2 and 3 (HDAC-123) with the HDAC schedule given on days 1, 3 and 5 (HDAC-135) as well as to evaluate the prophylactic use of pegfilgrastim after chemotherapy in younger patients with acute myeloid leukemia in first complete remission. One hundred and seventy-six patients were treated with HDAC-135 and 392 patients with HDAC-123 with prophylactic pegfilgrastim at days 10 and 8, respectively, in the AMLSG 07-04 and the German AML Intergroup protocol. Time from start to chemotherapy until hematologic recovery with white blood cells > 1.0 G/l and neutrophils > 0.5 G/l was in median 4 days shorter in patients receiving HDAC-123 compared with HDAC-135 (P < 0.0001, each), and further reduced by 2 days (P < 0.0001) by pegfilgrastim. Rates of infections were reduced by HDAC-123 (P < 0.0001) and pegfilgrastim (P = 0.002). Days in hospital and platelet transfusions were significantly reduced by HDAC-123 compared with HDAC-135. Survival was neither affected by HDAC-123 versus HDAC-135 nor by pegfilgrastim. In conclusion, consolidation therapy with HDAC-123 leads to faster hematologic recovery and less infections, platelet transfusions as well as days in hospital without affecting survival.