Myeloid growth factors in acute myeloid leukemia: systematic review of randomized controlled trials
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Myeloid growth factors in acute myeloid leukemia: systematic review of randomized controlled trials. / Heuser, Michael; Zapf, Antonia; Morgan, Michael; Krauter, Jürgen; Ganser, Arnold.
In: ANN HEMATOL, Vol. 90, No. 3, 03.2011, p. 273-281.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Myeloid growth factors in acute myeloid leukemia: systematic review of randomized controlled trials
AU - Heuser, Michael
AU - Zapf, Antonia
AU - Morgan, Michael
AU - Krauter, Jürgen
AU - Ganser, Arnold
PY - 2011/3
Y1 - 2011/3
N2 - Randomized controlled trials (RCT) investigating administration of colony-stimulating factors (CSF) during or after chemotherapy in acute myeloid leukemia (AML) patients have not been systematically reviewed. We performed a meta-analysis of all reported RCTs comparing prophylactic or concurrent use of CSFs in adult AML patients. Two reviewers extracted data independently. Summary estimates with 95% confidence intervals (CIs) were calculated using a fixed effects model. Fourteen RCTs (n = 4,069 patients) were identified investigating prophylactic CSF administration. Time to neutrophil recovery (>500/μl) was significantly reduced in the CSF group (-4.13 days; 95% CI, -4.23 to -4.04) as was the length of hospitalization (-2.06 days; 95% CI, -2.36 to -1.76). However, no significant reduction in infection-related mortality was observed in CSF-treated compared with control patients (odds ratio (OR) 0.94; 95% CI, 0.8 to 1.1). Prophylactic CSF administration did not impact complete remission (CR) rate or survival. Fourteen RCTs (n = 4,518 patients) were identified investigating administration of CSFs during chemotherapy. Summary estimates of CR, disease/event-free, or overall survival were not significantly different for CSF versus control patients. Prophylactic CSF administration reduces the time to neutrophil recovery and length of hospitalization, but has no impact on documented infections or outcome. Economic analyses of prophylactic CSF administration in AML patients are warranted.
AB - Randomized controlled trials (RCT) investigating administration of colony-stimulating factors (CSF) during or after chemotherapy in acute myeloid leukemia (AML) patients have not been systematically reviewed. We performed a meta-analysis of all reported RCTs comparing prophylactic or concurrent use of CSFs in adult AML patients. Two reviewers extracted data independently. Summary estimates with 95% confidence intervals (CIs) were calculated using a fixed effects model. Fourteen RCTs (n = 4,069 patients) were identified investigating prophylactic CSF administration. Time to neutrophil recovery (>500/μl) was significantly reduced in the CSF group (-4.13 days; 95% CI, -4.23 to -4.04) as was the length of hospitalization (-2.06 days; 95% CI, -2.36 to -1.76). However, no significant reduction in infection-related mortality was observed in CSF-treated compared with control patients (odds ratio (OR) 0.94; 95% CI, 0.8 to 1.1). Prophylactic CSF administration did not impact complete remission (CR) rate or survival. Fourteen RCTs (n = 4,518 patients) were identified investigating administration of CSFs during chemotherapy. Summary estimates of CR, disease/event-free, or overall survival were not significantly different for CSF versus control patients. Prophylactic CSF administration reduces the time to neutrophil recovery and length of hospitalization, but has no impact on documented infections or outcome. Economic analyses of prophylactic CSF administration in AML patients are warranted.
KW - Adult
KW - Anti-Bacterial Agents
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Bacterial Infections
KW - Colony-Stimulating Factors
KW - Humans
KW - Length of Stay
KW - Leukemia, Myeloid, Acute
KW - Neutropenia
KW - Randomized Controlled Trials as Topic
KW - Remission Induction
KW - Secondary Prevention
KW - Survival Rate
KW - Journal Article
KW - Meta-Analysis
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1007/s00277-010-1069-z
DO - 10.1007/s00277-010-1069-z
M3 - SCORING: Review article
C2 - 20838825
VL - 90
SP - 273
EP - 281
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 3
ER -