Acute Lymphocytic Leukemia

The effect of G-CSF both in the setting of remission induction and consolidation therapy has been tested in prospective trials, most of which were randomized. These trials were carried out in adults and children, both during remission induction and consolidation therapy. In the larger studies, duration of neutropenia was shortened by 5-8 days.33-39 At least in one acute lymphocytic leukemia trial conducted in adults, a trend toward increased complete response rate was also observed, but without improvement in survival.33 In general, there was no improvement in relapse-free or overall survival in any of the randomized trials using posttreatment G-CSF.

All of these studies demonstrated a decrease in the duration of neutropenia following the use of growth factors. The majority of studies also revealed decreased hospitalization, antibiotic use, and decrease in documented infections.39

Administration of G-CSF allowed for timely delivery and intensification of the planned chemotherapy cycles. Hence, G-CSF is recommended both following remission induction therapy, and consolidation, with an expectation to reduce the duration of absolute neu-tropenia by approximately 1 week, and in order to allow maintenance of dose intensity.

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