Different impacts of granulocyte colony‐stimulating factor administration on allogeneic hematopoietic cell transplant outcomes for adult acute myeloid leukemia according to graft type
We retrospectively evaluated the impacts of using granulocyte colony-stimulating factor (G-CSF) and its timing on posttransplant outcomes for 9766 adults with acute myeloid leukemia (AML) between 2013 and 2022 using a Japanese database. We separately evaluated three distinct cohorts based on graft type: 3248 received bone marrow transplantation (BMT), 3066 received peripheral blood stem cell transplantation (PBSCT), and 3452 received single-unit cord blood transplantation (CBT). Multivariate analysis showed that G-CSF administration significantly accelerated neutrophil recovery after BMT, PBSCT, and CBT. However, it was associated with a higher risk of grades II-IV acute graft-versus-host disease (GVHD) across all graft types. Moreover, an increased incidence of overall chronic GVHD was observed with G-CSF administration in BMT and CBT patients, but not in PBSCT patients. G-CSF administration significantly improved overall survival (OS) and leukemia-free survival (LFS) only following CBT. Regarding the timing of G-CSF, in comparison with late initiation of G-CSF (Days 5-10), early initiation (Days 0-4) did not provide benefits for hematopoietic recovery regardless of graft type. In contrast, late initiation was significantly associated with a lower risk of grades II-IV acute GVHD and better OS and LFS in CBT patients. These data demonstrated that G-CSF administration accelerated neutrophil recovery and increased the risk of grades II-IV acute GVHD across all graft types, but significantly improved survival outcomes but only following CBT. Therefore, routine use of G-CSF should be considered for CBT in adult patients with AML.
Authors
- Masatsugu Tanaka (ORCID: https://orcid.org/0000-0001-8814-230X)
- Naoyuki Uchida (ORCID: https://orcid.org/0000-0001-5952-5926)
- Yoshinobu Kanda (ORCID: https://orcid.org/0000-0002-4866-9307)
- Shin‐ichiro Fujiwara (ORCID: https://orcid.org/0000-0002-4523-2994)
- Mamiko Sakata‐Yanagimoto (ORCID: https://orcid.org/0000-0001-7310-8045)
- Yuta Hasegawa (ORCID: https://orcid.org/0000-0002-9925-2093)
- Noboru Asada (ORCID: https://orcid.org/0000-0001-7322-5460)
- Masamitsu Yanada (ORCID: https://orcid.org/0000-0003-1602-9775)
- Kaoru Morita (ORCID: https://orcid.org/0000-0003-2456-8189)
- Tadakazu Kondo (ORCID: https://orcid.org/0000-0002-8959-6271)
- Kazuaki Kameda (ORCID: https://orcid.org/0000-0001-8418-5118)
- Tetsuya Nishida
- Fumihiko Ishimaru (ORCID: https://orcid.org/0000-0002-7668-6083)
- Hideki Nakasone (ORCID: https://orcid.org/0000-0001-5812-9315)
- Shuichi Ota (ORCID: https://orcid.org/0000-0002-3631-244X)
- Makoto Onizuka (ORCID: https://orcid.org/0000-0003-3864-0823)
- Fumihiko Kimura (ORCID: https://orcid.org/0000-0001-6223-9904)
- Makoto Yoshimitsu (ORCID: https://orcid.org/0000-0002-5935-0385)
- Takaaki Konuma (ORCID: https://orcid.org/0000-0002-1953-8463)
- Marie Ohbiki (ORCID: https://orcid.org/0009-0007-3522-2278)
- Fumihiko Ouchi
- Takahiro Fukuda
- Satoshi Yoshihara
- Masashi Sawa
- Yoshiko Atsuta
Institutions
- Tokai University (JP)
- Jichi Medical University (JP)
- Aichi Medical University (JP)
- Japanese Red Cross Society, Japan (JP)
- Kanagawa Prefectural Hospital Organization (JP)
- Tokyo Metropolitan Komagome Hospital (JP)
- Nagoya City University (JP)
- Okayama University Hospital (JP)
- Sapporo Hokuyu Hospital (JP)
- University of Tsukuba Hospital (JP)
- Kagoshima University Hospital (JP)
- Japanese Red Cross Nagoya Daiichi Hospital (JP)
- Hokkaido University Hospital (JP)
- Anjo Kosei Hospital (JP)
- The Japanese Data Center for Hematopoietic Cell Transplantation (JP)
- Kobe City Medical Center General Hospital (JP)
- Jichi Medical University Saitama Medical Center (JP)
- Toranomon Hospital (JP)
- Kanagawa Cancer Center
- National Defense Medical College (JP)
- Nagoya University (JP)
- The University of Tokyo (JP)
Publication Details
- Journal
- American Journal of Hematology
- Published
- 2024-11-20
- DOI
- https://doi.org/10.1002/ajh.27521
- Citations
- 3
- Primary Topic
- Hematopoietic Stem Cell Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 1.36
Funders
- Japan Agency for Medical Research and Development