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. 2025 Feb 14;14(4):1254.
doi: 10.3390/jcm14041254.

Use of Primary Prophylaxis with G-CSF in Acute Myeloid Leukemia Patients Undergoing Intensive Chemotherapy Does Not Affect Quality of Response

Valeria Mezzanotte  1 , Giovangiacinto Paterno  2 , Ilaria Cerroni  1 , Lucrezia De Marchi  1 , Kristian Taka  1 , Elisa Buzzatti  1 , Flavia Mallegni  1 , Elisa Meddi  1 , Federico Moretti  1 , Francesco Buccisano  1 , Luca Maurillo  2 , Raffaele Palmieri  1 , Carmelo Gurnari  1 , Adriano Venditti  1 , Maria Ilaria Del Principe  1
Affiliations

Use of Primary Prophylaxis with G-CSF in Acute Myeloid Leukemia Patients Undergoing Intensive Chemotherapy Does Not Affect Quality of Response

Valeria Mezzanotte et al. J Clin Med. .

Abstract

Background/Objectives: The objective of our study was to evaluate the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis in adult patients with acute myeloid leukemia (AML) undergoing intensive chemotherapy. Methods: We retrospectively analyzed 112 AML patients treated with intensive chemotherapy at Fondazione Policlinico Tor Vergata in Rome between January 2014 and March 2024. Patients were divided into G-CSF and non-G-CSF (nG-CSF) groups. We assessed the incidence of neutropenia, its severity and duration; duration of hospitalization and its costs; incidence of febrile neutropenia (FN) and septic shock; duration of antibiotic therapy (ABT) and antifungal therapy (AFT); complete remission (CR) rates; measurable residual disease (MRD) status; relapse rates; and outcomes. Results: G-CSF administration significantly reduced the duration of neutropenia (median 14 vs. 18 days, p < 0.05) and length of hospitalization (median 28 vs. 35 days, p < 0.05), in both induction and consolidation therapy. There were no significant differences in CR rates (73% vs. 67%, p = 0.64), MRD negativity achievement (52% vs. 48%, p = 0.68), leukemia relapse rates (43% vs. 62%, p = 0.14), or overall survival (OS) (median 16.7 vs. 12.3 months, p = 0.3) between G-CSF and nG-CSF groups. Thanks to a shorter hospitalization, the use of G-CSF led to €300,000 in savings over the last 4 years. Conclusions: Our findings support the safety of G-CSF in AML patients, demonstrating no adverse impact on treatment response. G-CSF abbreviated the duration of neutropenia and hospitalization, highlighting its potential clinical and cost-effective role in AML treatment.

Keywords: acute myeloid leukemia; febrile neutropenia; granulocyte colony-stimulating factor.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier overall survival curves for G-CSF (red) and nG-CSF groups (blue).
Figure 2
Figure 2
Kaplan–Meier relapse-free survival curves for G-CSF (red) and nG-CSF groups (blue).
See this image and copyright information in PMC

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