Neutrophil recovery with or without G-CSF in non M3 AML patient with DA 3+7 protocol

Authors

  • Gazi Yeasinul Islam Dhaka Medical College Hospital https://orcid.org/0000-0002-2502-0943
  • Mohiuddin Ahmed Khan Dhaka Medical College
  • Mafruha Akter Dhaka Medical College https://orcid.org/0000-0003-2593-9703
  • H N Ashiqur Rahman National Institute of Cardiovascular Disease, Dhaka
  • Md. Ibrahim BSMMU, Dhaka
  • Md. Adnan Hasan Masud BSMMU, Dhaka
  • Md. Nurul Farhad Dhaka Medical College
  • A S M Tariqur Rabby ACDI (Agricultural Cooperative Development International)/VOCA (Volunteers in Overseas Cooperative Assistance)

DOI:

https://doi.org/10.37545/haematoljbd202062

Keywords:

neutrophil recovery, G-CSF, non M3 AML, DA 3 7 protocol

Abstract

Background: Induction of acute myeloid leukaemia is associated with a high incidence of treatment related mortality mostly due to neutropenia related infections. This study primarily analyses the duration of neutrophil recovery with or without G-CSF during induction with DA 3+7 in non M3 AML patients. This study also evaluates role of G-CSF in duration febrile neutropenia, hospital stay, total blood products transfusion, total number of used injectable antibiotics and remission status. Methods: It was a Quasi Experimental - Non-Randomized Controlled Trail. There were two groups a) Case = Patients receiving G-CSF b) Control= Patients not receiving G-CSF. Sampling was purposive sampling. Results:  50 patients in two group, G-CSF group (n=25) and Control group (No G-CSF) (n=25) participated in this study. Among them 54% was female and 46% was male. Median age of the participants was 28 years. Neutrophil recovery duration in G-CSF group Vs Control group showed 22.64 Vs 24.64 days (p value 0.003). Duration of febrile neutropenia in G-CSF group Vs Control group showed 11.24 Vs 13.56 days (p value 0.038). Duration of hospital stay in G-CSF group Vs Control group showed 23.64 Vs 25.76 days (p value 0.002). Total number of blood and blood product transfusion in G-CSF group Vs Control group showed 3.80 Vs 3.88 (p value 0.597). Total number of injectable antibiotics in G-CSF group Vs Control group showed 2.72 Vs 3.12 days (p value 0.169). In G-CSF group 22 (88%) and in Control group 23 (92%) were in complete remission (p value 0.637). Conclusions: G-CSF significantly reduces the duration of neutropenia (p value 0.003), febrile neutropenia (p value 0.038) and hospital stay (p value 0.002) after induction with DA 3+7. This may cause reduction in treatment cost and sepsis related mortality. G-CSF can’t significantly reduce use of blood products (p value 0.597) and injectable antibiotics (p value 0.169) after induction with DA 3+7. G-CSF does not affect morphological remission status (p value 0.637) after induction with DA 3+7.

Author Biographies

Gazi Yeasinul Islam, Dhaka Medical College Hospital

Medical Officer, Department of Haematology & BMT, Dhaka Medical College Hospital, Dhaka

Mohiuddin Ahmed Khan, Dhaka Medical College

Professor of Haematology, Dhaka Medical College, Dhaka

Mafruha Akter, Dhaka Medical College

Assistant Professor of Haematology, Dhaka Medical College, Dhaka

H N Ashiqur Rahman, National Institute of Cardiovascular Disease, Dhaka

Department of Cardiology National Institute of Cardiovascular Disease, Dhaka

Md. Ibrahim, BSMMU, Dhaka

Department of Radiology, BSMMU, Dhaka

Md. Adnan Hasan Masud, BSMMU, Dhaka

Consultant, Deapartment of Haematology, BSMMU, Dhaka

Md. Nurul Farhad, Dhaka Medical College

Assistant Professor of Haematology, Dhaka Medical College, Dhaka

A S M Tariqur Rabby, ACDI (Agricultural Cooperative Development International)/VOCA (Volunteers in Overseas Cooperative Assistance)

ACDI (Agricultural Cooperative Development International)/VOCA (Volunteers in Overseas Cooperative Assistance)

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Published

06.05.2021

How to Cite

1.
Islam GY, Khan MA, Akter M, Rahman HNA, Ibrahim M, Masud MAH, Farhad MN, Rabby ASMT. Neutrophil recovery with or without G-CSF in non M3 AML patient with DA 3+7 protocol. Haematol J Bangladesh [Internet]. 2021 May 6 [cited 2021 Oct. 19];5(01):15-9. Available from: https://journal.hematologybd.org/index.php/haematoljbd/article/view/62

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Original Article(s)