The aim of this study was to evaluate
G-CSF receptor (G-CSFr) expression on myeloid blasts, its prognostic significance and role in
growth factor use and the safety and efficacy of
G-CSF in the treatment of AML. Expression of G-CSFr, CD11a, CD11b, CD11c, CD13, CD33 and CD34 were analyzed with flow cytometry in 101 patients with AML aged 15-60 years. Results were reported as a percentage of positive cells. G-CSFr expression rate was found to be higher in M2 and M3 but lower in M5, M6 phenotypes, and in secondary
leukemia. Patients were randomized for
G-CSF use. Of 101 cases 51 received
G-CSF. The overall remission rate was 68.7%.
G-CSF use did not seem to have any effect on the remission rates. The median time to reach neutrophil counts > or = 1000/microliter in cases receiving
G-CSF was 23 days, and 28 days in the control group (p < 0.01).
G-CSF significantly reduced the number of febrile days (p < 0.01). Early and late relapses of 8 and 16 were observed during follow-up which was not effected by
G-CSF use. In patients who were G-CSFr(+),
G-CSF use did not alter overall survival rate. Univariate and multivariate analysis have revealed that not sex,
G-CSF use or G-CSFr but age, FAB subtype and performance status at diagnosis were the important factors on both overall and disease free survival. We have demonstrated no beneficial effect of G-CSFr analysis on in vivo
G-CSF use.