Granulocyte-macrophage colony-stimulating factor after initial chemotherapy for elderly patients with primary acute myelogenous leukemia

Article Abstract:

Treatment with granulocyte-macrophage colony stimulating factor (GM-CSF) does not appear to improve survival rates in elderly patients with acute myelogenous leukemia (AML). These naturally-occurring chemicals stimulate the production of immune cells. Many older AML patients do not respond as well to chemotherapy as younger patients. One theory suggests that older patients can not recover from the drop in white blood cells called neutrophils that is often caused by chemotherapy. Of 388 AML patients 60 years or older, 193 received daily infusions of GM-CSF and 195 received infusions of a placebo. Although neutrophil levels recovered more quickly in those receiving GM-CSF, the treatment did not improve remission rates or reduce the risk of developing infections. Fifty-one percent of those receiving GM-CSF went into remission, compared to 54% of those receiving a placebo. Survival rates were similar in both groups. GM-CSF did not stimulate the leukemia.

Granulocyte-macrophage colony stimulating factor

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A controlled study of recombinant human granulocyte colony-stimulating factor in elderly patients after treatment for acute myelogenous leukemia

Article Abstract:

Granulocyte colony stimulating factor (G-CSF) does not appear to reduce mortality rates in elderly patients with acute myelogenous leukemia (AML). G-CSF is often given to AML patients after chemotherapy because it reverses the drop in white blood cells called neutrophils that occurs during chemotherapy. Of 173 AML patients 65 years or older who had received chemotherapy, 88 received daily intravenous infusions of G-CSF and 85 received placebo infusions. Although G-CSF treatment significantly hastened the recovery of neutrophils, it did not reduce the infection rate compared to placebo. Seventy percent of those receiving G-CSF went into remission compared to 47% of those receiving placebo. However, 12-month survival rates were similar: 45% in those receiving G-CSF and 40% in those receiving placebo. Eight percent of those in each group experienced a re-growth of their leukemic cells, but G-CSF caused no other side effects.

Granulocyte colony-stimulating factor

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Differentiation therapy for acute promyelocytic leukemia

Article Abstract:

All-trans-retinoic acid appears to improve the prognosis of patients with acute promyelocytic leukemia when given in combination with chemotherapy. This type of leukemia is caused by the fusion of a gene on chromosome 15 with one on chromosome 17. The result is a fusion protein that prevents blood cell precursors from maturing. All-trans-retinoic acid appears to eliminate the fusion protein, thereby allowing the cancerous cells to mature. A 1997 study confirmed that all-trans-retinoic acid in combination with chemotherapy was more effective than chemotherapy alone in inducing remission and preventing relapse.

Health aspects, Editorial, Tretinoin

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