G-CSF May Improve Outcomes of Patients with Severe Aplastic Anemia

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G-CSF May Improve Outcomes of Patients with Severe Aplastic Anemia Treated with ATG and Cyclosporine

Researchers from Japan have reported that G-CSF (filgrastim, Kirin-Sankyo or lenograstim, Chugai) may improve outcomes of patients with aplastic anemia treated with ATG (anti-thymocyte globulin) and cyclosporine. The details of this study were published on-line in Blood on May 25, 2007.

The current treatment of choice for patients with aplastic anemia is ATG plus cyclosporine. The role of hematopoetic growth factors in this disease has not been established.

The current study involved 101 previously untreated patients with severe aplastic. Nintey-nine percent were idiopathic and 3 were associated with hepatitis B. The median age was 54 years with the oldest patient being 75 and the youngest being 19 years of age. Patients were randomly allocated to receive ATG and cyclosporine with or without G-CSF. G-CSF was administered for 84 days.

	No G-CSF	G-CSF
Number of Patients	47	48
Hematologic Response 3 months	51%	58%
Hematologic Response 6 months	77%	57%
Survival at 4 years	88%	94%
Relapse Rate at 4 years	42%	15%
AML or MDS	1 patient	2 patients

Comments: These data are suggestive that G-CSF may improve the response rate in patients with aplastic anemia. The most impressive statistic was the decrease in rate of relapse (return to transfusion dependence). These results will need to be confirmed in other trials before the routine use of G-CSF in this disease.

Refrences: Teramura M, Kimura A, Iwase S, et al. Treatment of severe aplastic anemia with antithymocyte globulin and cyclosporine A with or without G-CSF in adults; a multicenter randomized study in Japan. Blood. 2007; early on line publication on May 25, 2007.

Related News:

Long-Term Outcomes for Aplastic Anemia Treated with Immunosuppression Defined (03/12/2003)

Long-Term Study Confirms Benefit of Cyclosporine in Immunosuppressive Regimen Treatment of Aplastic Anemia (02/11/2003)

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