Effectiveness and Safety of G-CSF for Acute Lymphoblastic Leukemia: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

LI Pei ,  XI Yaming , XU Jianwang , ZHANG Hao , LI Ming , DENG Wei

Institute of Hematology and Department of Hematology, The First Clinical Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

XI Yaming, Email: xiyaming02@163.com

Keywords：

Granulocyte colony stimulating factor; Acute lymphoblastic leukemia; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20100530

Video：

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Objective To assess the clinical effectiveness and safety of granulocyte colony stimulating factor (G-CSF) for patients with acute lymphoblastic leukemia (ALL).
Methods We searched the Cochrane Library, PubMed, EMbase, CNKI, and VIP databases from January 2000 to October 2009. Randomized controlled trials (RCTs) about G-CSF for patients with ALL were retrieved. The methodological quality of the included studies was assessed and the data was extracted according the Cochrane Reviewer’s Handbook. Meta-analyses for overall survival, complete remission, quality of life, infections, relapse rate, and adverse events were performed using RevMan 5.0 software.
Results Six RCTs involving 620 patients with ALL were included. The results of meta-analyses showed that the G-CFS group was superior to the control group in the overall survival of adult ALL patients (RR=2.24, 95%CI 1.28 to 3.90, P=0.004).
Conclusion G-CSF can improve the overall survival of adult ALL patients. However, it is not demonstrated that G-CSF could improve complete remission rate and quality of life, and reduce infections and relapse rate. More high-quality and large scale RCTs are required.

Citation： LI Pei,XI Yaming,XU Jianwang,ZHANG Hao,LI Ming,DENG Wei. Effectiveness and Safety of G-CSF for Acute Lymphoblastic Leukemia: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(8): 985-990. doi: 10.7507/1672-2531.20100530 Copy

1.	Pui CH. Childhood leukemias. N Engl J Med, 1995, 332(24): 1618-1630.
2.	秘营昌, 王建祥. 我国急性白血病的诊断治疗现状. 国际输血及血液学杂志, 2006, 29(04): 290-291.
3.	Mortuza FY, Papaioannou M, Moreira M. Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. J Clin Oncol, 2002, 20(4): 1094-1104.
4.	Schrappe M, Reiter A, Zimmermann M, et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Berlin-Frankfurt-Munster. Leukemia, 2000, 14(12): 2205-2222.
5.	Bronchud MH, Potter MR, Morgenstern G, et al. In vitro and in vivo analysis of the effects of recombinant human granulocyte colony-stimulating factor in patients. Br J Cancer, 1988, 58(1): 64-69.
6.	Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med, 1991, 325(3): 164-170.
7.	Chen SH, Liang DC, Liu HC. High-dose cytarabine-containing chemotherapy with or without granulocyte colony-stimulating factor for children with acute leukemia. Am J Hematol, 1998, 58(1): 20-23.
8.	Lifton R, Bennett JM. Clinical use of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor in neutropenia associated with malignancy. Hematol Oncol Clin North Am, 1996, 10(4): 825-839.
9.	Laver J, Amylon M, Desai S, et al. Randomized trial of r-metHu granulocyte colony-stimulating factor in an intensive treatment for T-cell leukemia and advanced-stage lymphoblastic lymphoma of childhood: a pediatric oncology group pilot study. J Clin Oncol, 1998, 16(2): 522-526.
10.	Pui CH, Boyett JM, Hughes WT, et al. Human granulocyte colony-stimulating factor after induction chemotherapy in children with acute lymphoblastic leukemia. N Engl J Med, 1997, 336(25): 1781-1787.
11.	Little MA, Morland B, Chisholm J, et al. A randomised study of prophylactic G-CSF following MRC UKALL XI intensification regimen in childhood ALL and T-NHL. Med Pediatr Oncol, 2002, 38(2): 98-103.
12.	Elting LS, Cantor SB. Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices. Support Care Cancer, 2002, 10(3): 189-196.
13.	Sasse EC, Sasse AD, Brandalise SR, et al. Colony-stimulating factors for prevention of myelosuppressive therapy-induced febrile neutropenia in children with acute lymphoblastic leukaemia. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004139. DOI: 10.1002/14651858.CD004139.pub2.
14.	范娟, 万朝敏, 舒敏, 等. 集落刺激因子在小儿急性淋巴细胞白血病中应用的系统评价证据. 临床儿科杂志, 2006, 24(02): 147-149.
15.	Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol, 1976, 33(4): 451-458.
16.	秘营昌, 卞寿庚. 见: 张之南, 沈悌, 主编. 血液病诊断及疗效标准. 第三版. 北京: 科学出版社, 2007: 116-121.
17.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
18.	Michel G, Landman-Parker J, Auclerc MF, et al. Use of recombinant human granulocyte colony-stimulating factor to increase chemotherapy dose-intensity: a randomized trial in very high-risk childhood acute lymphoblastic leukemia. J Clin Oncol, 2000, 18(7): 1517-1524.
19.	Holowiecki J, Giebel S, Krzemien S, et al. G-CSF administered in time-sequenced setting during remission induction and consolidation therapy of adult acute lymphoblastic leukemia has beneficial influence on early recovery and possibly improves long-term outcome: a randomized multicenter study. Leuk Lymphoma, 2002, 43(2): 315-325.
20.	Heath JA, Steinherz PG, Altman A, et al. Human granulocyte colony-stimulating factor in children with high-risk acute lymphoblastic leukemia: a Children’s Cancer Group Study. J Clin Oncol, 2003, 21(8): 1612-1617.
21.	Thomas X, Boiron JM, Huguet F, et al. Efficacy of granulocyte and granulocyte-macrophage colony-stimulating factors in the induction treatment of adult acute lymphoblastic leukemia: a multicenter randomized study. Hematol J, 2004, 5(5): 384-394.
22.	刘秋玲, 杨玉兰, 马伏英, 等. 重组人粒细胞集落刺激因子在小儿急性淋巴细胞白血病化疗中的应用. 武警医学, 2001, 12(1): 10-12.
23.	何静, 陈燕, 舒文秀. Dvclp方案联用粒细胞集落刺激因子对成人急性淋巴细胞白血病诱导缓解治疗的临床研究. 临床内科杂志, 2006, 23(7): 467-469.
24.	Steinherz PG, Gaynon P, Miller DR, et al. Improved disease-free survival of children with acute lymphoblastic leukemia at high risk for early relapse with the New York regimen--a new intensive therapy protocol: a report from the Childrens Cancer Study Group. J Clin Oncol, 1986, 4(5): 744-752.
25.	Steinherz PG, Redner A, Steinherz L, et al. Development of a new intensive therapy for acute lymphoblastic leukemia in children at increased risk of early relapse. The Memorial Sloan-Kettering-New York-II protocol. Cancer, 1993, 72(10): 3120-3130.
26.	Sung L, Klaassen RJ, Dix D, et al. Identification of paediatric cancer patients with poor quality of life. Br J Cancer, 2009, 100(1): 82-88.
27.	史明丽, 编译. 癌症领域中生存质量的定义、目的及测定方法. 国外医学社会医学分册, 1996, 13(2): 68-73.

1. Pui CH. Childhood leukemias. N Engl J Med, 1995, 332(24): 1618-1630.
2. 秘营昌, 王建祥. 我国急性白血病的诊断治疗现状. 国际输血及血液学杂志, 2006, 29(04): 290-291.
3. Mortuza FY, Papaioannou M, Moreira M. Minimal residual disease tests provide an independent predictor of clinical outcome in adult acute lymphoblastic leukemia. J Clin Oncol, 2002, 20(4): 1094-1104.
4. Schrappe M, Reiter A, Zimmermann M, et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Berlin-Frankfurt-Munster. Leukemia, 2000, 14(12): 2205-2222.
5. Bronchud MH, Potter MR, Morgenstern G, et al. In vitro and in vivo analysis of the effects of recombinant human granulocyte colony-stimulating factor in patients. Br J Cancer, 1988, 58(1): 64-69.
6. Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N Engl J Med, 1991, 325(3): 164-170.
7. Chen SH, Liang DC, Liu HC. High-dose cytarabine-containing chemotherapy with or without granulocyte colony-stimulating factor for children with acute leukemia. Am J Hematol, 1998, 58(1): 20-23.
8. Lifton R, Bennett JM. Clinical use of granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor in neutropenia associated with malignancy. Hematol Oncol Clin North Am, 1996, 10(4): 825-839.
9. Laver J, Amylon M, Desai S, et al. Randomized trial of r-metHu granulocyte colony-stimulating factor in an intensive treatment for T-cell leukemia and advanced-stage lymphoblastic lymphoma of childhood: a pediatric oncology group pilot study. J Clin Oncol, 1998, 16(2): 522-526.
10. Pui CH, Boyett JM, Hughes WT, et al. Human granulocyte colony-stimulating factor after induction chemotherapy in children with acute lymphoblastic leukemia. N Engl J Med, 1997, 336(25): 1781-1787.
11. Little MA, Morland B, Chisholm J, et al. A randomised study of prophylactic G-CSF following MRC UKALL XI intensification regimen in childhood ALL and T-NHL. Med Pediatr Oncol, 2002, 38(2): 98-103.
12. Elting LS, Cantor SB. Outcomes and costs of febrile neutropenia: adventures in the science and art of treatment choices. Support Care Cancer, 2002, 10(3): 189-196.
13. Sasse EC, Sasse AD, Brandalise SR, et al. Colony-stimulating factors for prevention of myelosuppressive therapy-induced febrile neutropenia in children with acute lymphoblastic leukaemia. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004139. DOI: 10.1002/14651858.CD004139.pub2.
14. 范娟, 万朝敏, 舒敏, 等. 集落刺激因子在小儿急性淋巴细胞白血病中应用的系统评价证据. 临床儿科杂志, 2006, 24(02): 147-149.
15. Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol, 1976, 33(4): 451-458.
16. 秘营昌, 卞寿庚. 见: 张之南, 沈悌, 主编. 血液病诊断及疗效标准. 第三版. 北京: 科学出版社, 2007: 116-121.
17. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
18. Michel G, Landman-Parker J, Auclerc MF, et al. Use of recombinant human granulocyte colony-stimulating factor to increase chemotherapy dose-intensity: a randomized trial in very high-risk childhood acute lymphoblastic leukemia. J Clin Oncol, 2000, 18(7): 1517-1524.
19. Holowiecki J, Giebel S, Krzemien S, et al. G-CSF administered in time-sequenced setting during remission induction and consolidation therapy of adult acute lymphoblastic leukemia has beneficial influence on early recovery and possibly improves long-term outcome: a randomized multicenter study. Leuk Lymphoma, 2002, 43(2): 315-325.
20. Heath JA, Steinherz PG, Altman A, et al. Human granulocyte colony-stimulating factor in children with high-risk acute lymphoblastic leukemia: a Children’s Cancer Group Study. J Clin Oncol, 2003, 21(8): 1612-1617.
21. Thomas X, Boiron JM, Huguet F, et al. Efficacy of granulocyte and granulocyte-macrophage colony-stimulating factors in the induction treatment of adult acute lymphoblastic leukemia: a multicenter randomized study. Hematol J, 2004, 5(5): 384-394.
22. 刘秋玲, 杨玉兰, 马伏英, 等. 重组人粒细胞集落刺激因子在小儿急性淋巴细胞白血病化疗中的应用. 武警医学, 2001, 12(1): 10-12.
23. 何静, 陈燕, 舒文秀. Dvclp方案联用粒细胞集落刺激因子对成人急性淋巴细胞白血病诱导缓解治疗的临床研究. 临床内科杂志, 2006, 23(7): 467-469.
24. Steinherz PG, Gaynon P, Miller DR, et al. Improved disease-free survival of children with acute lymphoblastic leukemia at high risk for early relapse with the New York regimen--a new intensive therapy protocol: a report from the Childrens Cancer Study Group. J Clin Oncol, 1986, 4(5): 744-752.
25. Steinherz PG, Redner A, Steinherz L, et al. Development of a new intensive therapy for acute lymphoblastic leukemia in children at increased risk of early relapse. The Memorial Sloan-Kettering-New York-II protocol. Cancer, 1993, 72(10): 3120-3130.
26. Sung L, Klaassen RJ, Dix D, et al. Identification of paediatric cancer patients with poor quality of life. Br J Cancer, 2009, 100(1): 82-88.
27. 史明丽, 编译. 癌症领域中生存质量的定义、目的及测定方法. 国外医学社会医学分册, 1996, 13(2): 68-73.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of G-CSF for Acute Lymphoblastic Leukemia: A Systematic Review

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