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Prolonged progression-free survival in patients with chronic lymphocytic leukemia receiving granulocyte colony-stimulating factor during treatment with fludarabine, cyclophosphamide, and rituximab

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Abstract

The clinical benefit of the addition of granulocyte colony-stimulating factor (G-CSF) to standard immunochemotherapy of chronic lymphocytic leukemia (CLL) with fludarabine, cyclophosphamide, and rituximab (FCR) is still unclear. In this retrospective study we analyzed the outcome of 32 consecutive patients with CLL during treatment with FCR. Sixteen patients received G-CSF for treatment of CTC grade 3 or 4 neutropenia or febrile neutropenia at some point during therapy and 16 did not. Both groups were well balanced for clinical and biological risk factors. Overall response rates were not significantly different (94% vs. 75%; p = 0.144). Interestingly, a significantly better progression-free survival (100% vs. 35.4% at 24 months; p < 0.001) and even overall survival (100% vs. 77.8% at 24 months; p = 0.022) was observed in patients receiving G-CSF. While the underlying cause remains to be elucidated, these data strongly suggest an association of the addition of G-CSF to FCR therapy with final patient outcome.

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Acknowledgments

The authors are grateful to Bernadette Hilgarth and Martin Hilgarth for technical assistance as well as Michaela Bronhagl for preparation of the manuscript.

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Authors and Affiliations

  1. Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Michaela Gruber, Karin Fleiss, Edit Porpaczy, Cathrin Skrabs, Alexander W. Hauswirth, Alexander Gaiger, Katrina Vanura, Daniel Heintel, Medhat Shehata, Christine Einberger & Ulrich Jäger

  2. Clinical Institute for Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Renate Thalhammer

  3. Institute of Human Genetics, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Christa Fonatsch

  4. Comprehensive Cancer Center (CCC), Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Ulrich Jäger

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  1. Michaela Gruber
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  2. Karin Fleiss
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  3. Edit Porpaczy
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  4. Cathrin Skrabs
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  5. Alexander W. Hauswirth
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  6. Alexander Gaiger
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  7. Katrina Vanura
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  8. Daniel Heintel
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  9. Medhat Shehata
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  10. Christine Einberger
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  11. Renate Thalhammer
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  13. Ulrich Jäger
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Corresponding author

Correspondence to Ulrich Jäger.

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Michaela Gruber and Karin Fleiss contributed equally to the manuscript.

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Gruber, M., Fleiss, K., Porpaczy, E. et al. Prolonged progression-free survival in patients with chronic lymphocytic leukemia receiving granulocyte colony-stimulating factor during treatment with fludarabine, cyclophosphamide, and rituximab. Ann Hematol 90, 1131–1136 (2011). https://doi.org/10.1007/s00277-011-1260-x

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  • DOI: https://doi.org/10.1007/s00277-011-1260-x

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