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Granulocyte-colony stimulating factor (filgrastim) accelerates granulocyte
recovery after intensive postremission chemotherapy for acute myeloid
leukemia with aziridinyl benzoquinone and mitoxantrone: Cancer and Leukemia
Group B study 9022
JO Moore, RK Dodge, PC Amrein, J Kolitz, EJ Lee, B Powell, S Godfrey, F Robert and CA Schiffer
Division of Hematology/Oncology, Duke University Medical Center, Durham, NC
27710, USA.
This study evaluated the effect of filgrastim (granulocyte colony-
stimulating factor [G-CSF]) on the duration of granulocytopenia and
thrombocytopenia after intensive consolidation therapy with diaziquone
(AZO) and mitroxantrone for patients less than 60 years of age with acute
myeloid leukemia (AML) in complete remission. Patients less than 60 years
of age with AML who achieved complete remission (CR) with daunorubicin and
cytarabine induction therapy, were scheduled to receive three sequential
courses of high-dose cytarabine, cyclophosphamide/etoposide, AZQ, and
mitroxantrone in a pilot study to determine their tolerance of these three
sequential consolidation regimens. The initial patients treated with AZQ
and mitroxantrone experienced prolonged bone marrow suppression and,
therefore, subsequent cohorts were treated with G-CSF, 5 micrograms/kg,
beginning the day after completion of the third cycle of chemotherapy.
There was a marked decrease in the duration of granulocytopenia less than
500/microL in two groups of patients receiving two different dose levels of
AZQ and the same dose of mitoxantrone compared with patients not receiving
the G-CSF. There was also a decrease in the need for hospitalization, as
well as the duration of hospitalization. There was a trend towards
shortening of the duration of thromobocytopenia, as well. The duration of
complete remission and overall survival was similar in patients who
received or did not receive G-CSF. G-CSF markedly shortened the duration of
granulocytopenia in patients with AML receiving intensive postremission
consolidation with AZQ and mitoxantrone. There was no adverse effect on CR
duration or survival.
Volume 89,
Issue 3,
pp. 780-788,
02/01/1997
Copyright © 1997 by The American Society of Hematology
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