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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2794-2796. Prepublished online as a Blood First Edition Paper on November 16, 2006; DOI 10.1182/blood-2006-07-034272.
CLINICAL TRIALS AND OBSERVATIONS Granulocyte-stimulating factor and severe aplastic anemia: a survey by the European Group for Blood and Marrow Transplantation (EBMT)1 Service d'Hématologie Greffe, and Institut National de la Santé et de la Recherche Médicale (INSERM) U728, Hospital Saint Louis, Paris, France; 2 INSERM U717, University Paris VII, and Département de Biostatistique et Informatique Médicale (DBIM) Hospital Saint Louis, Paris, France; 3 University of Ulm, Institute for Transfusion Medicine, and Institut für Klinische Transfusionmedizin und Immunogenetik (IKT) Ulm, Ulm, Germany; 4 Hematology, Saint George Hospital, London, United Kingdom; 5 Department of Hematology, Hospital San Martino, Genova, Italy; 6 Department of Hematology, Hospital San Camillo, Rome, Italy; 7 Children Hospital, University of Munich, Munich, Germany; 8 Department of Hematology, University Hospital, Lund, Sweden; 9 Department of Hematology, University Hospital, Basel, Switzerland; 10 Department of Hematology, Geneva Hospital, Geneva, Switzerland Previous studies suggested a link between the use of G-CSF and increased incidence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) after immunosuppressive therapy (IST) for severe aplastic anemia (SAA). This European survey included 840 patients who received a first-line IST with (43%) or without (57%) G-CSF. The incidences of MDS/AML in patients who did or did not receive G-CSF were 10.9% and 5.8%, respectively. A significantly higher hazard (1.9) of MDS/AML was associated with use of G-CSF. Relapse of aplastic anemia was not associated with a worse outcome in patients who did not receive G-CSF as first therapy, whereas relapse was associated with a significantly worse outcome in those patients who received G-CSF. These results emphasize the necessity of the current European randomized trial comparing IST with or without G-CSF and to alert physicians that adding G-CSF to IST is currently not standard treatment for SAA.
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