The Effect of Prophylactic Administration of Myeloid Growth Factors Following Autologous Stem Cell Transplantation for Patients with Hematological Malignancies: A Systematic Review.
Notice bibliographique
Résumé
Abstract BACKGROUND. Myeloid growth factors (G-CSF, GM-CSF) are often administered following autologous stem cell transplantation to reduce the duration of neutropenia and limit infection-related morbidity and mortality. OBJECTIVES. (1) To determine if prophylactic myeloid growth factors (GF) administered to adult patients undergoing autologous stem cell transplantation for a hematological malignancy improve clinical outcomes post-transplant, and (2) to determine the optimal dose and schedule for the administration of GF post-transplantation. METHODS. Computerized databases were searched for reports from 1966 to March 2004. Reference lists from published reports were hand searched and published abstracts were also considered. Randomized trials comparing different GF regimens were selected by two independent assessors based on explicit inclusion and exclusion criteria; disagreement was resolved by consensus. Two independent reviewers blinded to authors, institution, journal name, and results used a validated scale to assess study quality. When possible, study results were pooled using a random effects model to obtain a pooled relative risk. RESULTS. Of 985 citations identified, 27 studies evaluating 2268 patients were included. Studies were grouped and analyzed according to their control and experimental arms: (1) early administration of growth factor (< day +3 post-transplant) compared with placebo or no growth factor (N=18 studies), (2) early administration of growth factor compared with delayed growth factor (> day +3, N=8 studies), and (3) high doses of GF (> 5ug/kg/d) compared to standard/low doses of GF (<5ug/kg/d, N=5 studies). Compared to no GF support, early administration of GF resulted in a statistically significant reduction in the median days to neutrophil engraftment (>0.5x109/L) in 14 of 15 studies (range 2–13 days). The magnitude of this benefit was diminished when only studies of higher methodologic quality and optimal transplant conditions (peripheral blood stem cells) were considered (range 2–3 days). A significant decrease in duration of hospitalization was reported in 8 of 15 studies; however no consistent benefit was observed for median days of i.v. antibiotics (3 of 10 studies), median days of fever (1 of 10 studies), or in the rate of microbiologically documented infections (RR 0.94, 95% CI 0.69–1.29). Compared to delayed administration of GF, early administration of GF was not associated with a significant difference in median duration of neutropenia any of 5 studies. Only 1 study reported a significant difference in the median duration of hospitalization and median days of i.v. antibiotics and it was of lower methodological quality. No difference in the rate of microbiologically documented infections was detected (RR 1.29, 95% CI 0.83–2.03). Compared to standard doses of GF, no study evaluating high dose GF reported a statistically significant improvement in any reported outcome but treatment was more costly owing to an increase in total GF administered. CONCLUSION. The administration of GF post-autologous stem cell transplant reduces the time to neutrophil engraftment and may reduce length of hospital stay. The effectiveness of delayed administration of standard dose GF (5 ug/kg/d) appears similar to strategies that initiate GF support immediately post-transplant or utilize high doses.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,028 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,006 |
| Bibliométrie | 0,005 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».