The Risk of Clonal Evolution of Granulocyte Colony-Stimulating Factor for Acquired Aplastic Anemia: A Systematic Review and Meta-Analysis.

Abstract

OBJECTIVES:

This meta-analysis aimed to evaluate the risk of clonal evolution of granulocyte colony-stimulating factor (G-CSF) in acquired aplastic anemia (AA), and whether the use of G-CSF increases the occurrence of secondary malignant neoplasms, mainly myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) or paroxysmal nocturnal hemoglobinuria (PNH).

METHODS:

Data were gathered from randomized controlled trials (RCTs) to evaluate the effect of G-CSF versus no G-CSF at the risk of developing the clonal complications of acquired AA. Electronic searches in PubMed, Embase, and the Cochrane Library were performed to identify studies up to 1 January 2017. Only RCTs performed on patients who were randomly assigned to receive G-CSF or not to receive G-CSF were included.

RESULTS:

Four relevant trials that met the inclusion criteria were identified. In a pooled analysis, the G-CSF groups of AA patients were not associated with a statistically significant higher occurrence of secondary malignant neoplasm, mainly MDS and AML (relative risk [RR] 0.86; 95% confidence interval [CI] 0.34-2.19; 4 trials). No significant heterogeneity was found (p = 0.67, I2 = 0%). There was no statistically significant higher occurrence of PNH in the G-CSF groups with AA (RR 1.17; 95% CI 0.51-2.71; 4 trials) and no significant heterogeneity was found (p = 0.42, I2 = 0%).

CONCLUSIONS:

G-CSF for patients with AA is not associated with a higher occurrence of secondary malignant neoplasm, mainly MDS/AML, or PNH.

• Authors: Shao-Xue Ding, Tong Chen, Ting Wang, Chun-Yan Liu, Wen-Li Lu, Rong Fu
• Journal: Acta haematologica (Acta Haematol) Vol. 140 Issue 3 Pg. 141-145 ( 2018) ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 30253387 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2018 S. Karger AG, Basel.

Chemical References

• Granulocyte Colony-Stimulating Factor

Topics

• Anemia, Aplastic (metabolism, pathology)
• Clonal Evolution
• Databases, Factual
• Granulocyte Colony-Stimulating Factor (metabolism)
• Humans
• Randomized Controlled Trials as Topic
• Risk