GRANULOCYTE-COLONY-STIMULATING FACTOR (FILGRASTIM) ACCELERATES GRANULOCYTE RECOVERY AFTER INTENSIVE POSTREMISSION CHEMOTHERAPY FOR ACUTE MYELOID-LEUKEMIA WITH AZIRIDINYL BENZOQUINONE AND MITOXANTRONE - CANCER AND LEUKEMIA GROUP-B STUDY-9022

This study evaluated the effect of filgrastim (granulocyte colony-stim ulating factor [G-CSF]) on the duration of granulocytopenia and thromb ocytopenia after intensive consolidation therapy with diaziquone (AZQ) and mitroxanfrone for patients less than 60 years of age with acute m yeloid leukemia (AML) in complete remission. Patients less than 60 yea rs of age with AML who achieved complete remission (CR) with daunorubi cin and cytarabine induction therapy, were scheduled to receive three sequential courses of high-dose cytarabine, cyclophosphamide/etaposide , AZQ, and mitroxantrone in a pilot study to determine their tolerance of these three sequential consolidation regimens. The initial patient s treated with AZQ and mitoxantrone experienced prolonged bone marrow suppression and, therefore, subsequent cohorts were treated with G-CSF , 5 mu g/kg, beginning the day after completion of the third cycle of chemotherapy. There was a marked decrease in the duration of granulocy topenia less than 500/mu L in two groups of patients receiving two dif ferent dose levels of AZQ and the same dose of mitoxantrone compared w ith patients not receiving the G-CSF, There was also a decrease in the need for hospitalization, as well as the duration of hospitalization. There was a trend towards shortening of the duration of thrombocytope nia, as well. The duration of complete remission and overall survival was similar in patients who received or did not receive G-CSF. G-CSF m arkedly shortened the duration of granulocytopenia in patients with AM L receiving intensive postremission consolidation with AZQ and mitoxan trone. There was no adverse effect on CR duration or survival. (C) 199 7 by The American Society of Hematology.