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Blood Cancer J. 2017 May 26;7(5):e564. doi: 10.1038/bcj.2017.45.

Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia.

Author information

1
Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.
2
Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany.
3
Department of Oncology and Hematology, Klinikum Braunschweig, Braunschweig, Germany.
4
Department of Internal Medicine II, University Hospital, Frankfurt, Germany.
5
Department of Medicine III, Johannes Gutenberg-University Mainz, Mainz, Germany.
6
Department of Internal Medicine III, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
7
Department of Hematology and Oncology, Eberhard-Karls University, Tübingen, Germany.
8
Department of Internal Medicine I, University Hospital of Saarland, Homburg, Germany.
9
Department of Oncology and Hematology, Klinikum Oldenburg, Oldenburg, Germany.
10
Department of Internal Medicine III, Technical University of Munich, Munich, Germany.
11
Department of Hematology and Oncology, University Hospital of Freiburg, Freiburg, Germany.
12
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Düsseldorf, Germany.
13
Department of Internal Medicine III, University Hospital of Bonn, Bonn, Germany.
14
Department of Hematology, Oncology and Stem Cell Transplantation, Klinikum Essen Süd, Essen, Germany.
15
Department of Hematology and Oncology, Asklepios Klinik Altona, Hamburg, Germany.
16
Department of Internal Medicine I, Klinikum Bremen Mitte, Bremen, Germany.
17
Department of Internal Medicine V, University Hospital Innsbruck, Innsbruck, Austria.
18
Department of Hematology and Oncology, University Hospital of Göttingen, Göttingen, Germany.
19
Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel, Germany.
20
Department of Internal Medicine I, Krankenhaus der Barmherzigen Brüder, Trier, Germany.
21
Department of Internal Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
22
Department of Internal Medicine I, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany.
23
Department of Internal Medicine III, University of Salzburg, Salzburg, Austria.
24
Department of Hematology/Oncology, Caritas Krankenhaus Lebach, Lebach, Germany.
25
Department of Internal Medicine III, Hanuschkrankenhaus, Wien, Austria.
26
Department of Hematology/Oncology, Wilhelm-Anton Hospital Goch, Goch, Germany.
27
Department of Internal Medicine V, Klinikum Lüdenscheid, Lüdenscheid, Germany.
28
Institute of Human Genetics, Hannover Medical School, Hannover Germany.
29
Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
30
NCT Trial Center, National Center for Tumor Diseases, Heidelberg, Germany.

Abstract

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.

PMID:
28548643
PMCID:
PMC5518888
DOI:
10.1038/bcj.2017.45
[Indexed for MEDLINE]
Free PMC Article

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