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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.
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Submitted July 10, 2006
Accepted November 13, 2006
Granulocyte-stimulating factor and severe aplastic anemia
A survey by the European Group for Blood and Marrow
Transplantation (EBMT)
Gerard Socie*, Jean-Yves Mary, Hubert Schrezenmeier, Judith Marsh, Andrea Bacigalupo, Anna Locasciulli, Monica Fuehrer, Albert Bekassy, Andre Tichelli, and Jakob Passweg
Service d'Hematologie Greffe, INSERM U728, Hospital St Louis, Paris, France
INSERM U717, University Paris VII, Paris, France
Institute for Transfusion Medicine, University of Ulm, Ulm, Germany
Hematology, St Georges Hospital, London, United Kingdom
Department of Hematology, St Martino Hospital, Genova, Italy
Department of Hematology, St Camillo Hospital, Rome, Italy
Children Hospital, University of Munich, Munich, Germany
Department of Hematology, University Hospital Lund, Lund, Sweden
Department of Hematology, University Hospital Basel, Basel, Switzerland
Department of Hematology, Geneva Hospital, Geneva, Switzerland
* Corresponding author; email: gerard.socie{at}paris7.jussieu.fr.
Previous studies suggested a link between the use of G-CSF and increased incidence of MDS and 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%. A significant 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, while 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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