%0 Journal Article
%T Effectiveness and safety of granulocyte colony-stimulating factor priming regimen for acute myeloid leukemia: A systematic review and meta-analysis of the Clinical Practice Guideline for the use of G-CSF 2022 from the Japan Society of Clinical Oncology.
%A Najima Y
%A Maeda T
%A Kamiyama Y
%A Nakao S
%A Ozaki Y
%A Nishio H
%A Tsuchihashi K
%A Ichihara E
%A Miumra Y
%A Endo M
%A Maruyama D
%A Yoshinami T
%A Susumu N
%A Takekuma M
%A Motohashi T
%A Ito M
%A Baba E
%A Ochi N
%A Kubo T
%A Uchino K
%A Kimura T
%A Tamura S
%A Nishimoto H
%A Kato Y
%A Sato A
%A Takano T
%A Yano S
%J Int J Clin Oncol
%V 29
%N 7
%D 2024 Jul 17
%M 38755516
%F 3.85
%R 10.1007/s10147-023-02461-4
%X <B>BACKGROUND: </B>The outcomes of relapsed or refractory acute myeloid leukemia (AML) remain poor. Although the concomitant use of granulocyte colony-stimulating factor (G-CSF) and anti-chemotherapeutic agents has been investigated to improve the antileukemic effect on AML, its usefulness remains controversial. This study aimed to investigate the effects of G-CSF priming as a remission induction therapy or salvage chemotherapy.<BR><B>METHODS: </B>We performed a thorough literature search for studies related to the priming effect of G-CSF using PubMed, Ichushi-Web, and the Cochrane Library. A qualitative analysis of the pooled data was performed, and risk ratios (RRs) with confidence intervals (CIs) were calculated and summarized.<BR><B>RESULTS: </B>Two reviewers independently extracted and accessed the 278 records identified during the initial screening, and 62 full-text articles were assessed for eligibility in second screening. Eleven studies were included in the qualitative analysis and 10 in the meta-analysis. A systematic review revealed that priming with G-CSF did not correlate with an improvement in response rate and overall survival (OS). The result of the meta-analysis revealed the tendency for lower relapse rate in the G-CSF priming groups without inter-study heterogeneity [RR, 0.91 (95% CI 0.82-1.01), p = 0.08; I2 = 4%, p = 0.35]. In specific populations, including patients with intermediate cytogenetic risk and those receiving high-dose cytarabine, the G-CSF priming regimen prolonged OS.<BR><B>CONCLUSIONS: </B>G-CSF priming in combination with intensive remission induction treatment is not universally effective in patients with AML. Further studies are required to identify the patient cohort for which G-CSF priming is recommended.