Abstract 2968: Effect of Granulocyte-Colony Stimulating Factor on Systolic Function of Oncology Patients
Administration of Granulocyte Colony Stimulating Factor (GCSF) to improve left ventricular function has no benefit in human studies of ischemic cardiomyopathy; the effect on non ischemic population have not been fully assessed. Although, animal model of Adriamycin induced cardiomyopathy showed protection in the ejection fraction (EF) by GCSF. We selected a group of oncology patients that receive high doses of GCSF for prevention and treatment of chemotherapy induced neutropenia and had evaluation of their EF before and after treatments.
Methods: This is a retrospective cohort study from a University of Miami affiliated hospital; we identified all oncology patients GCSF recipients between October 2007 and September 2008, and selected those patients who had an echocardiogram before and after receiving GCSF. Our control group consisted of oncology patients admitted in the same dates who did not receive GCSF before or in between their 2 echocardiograms. We evaluated echocardiographic parameters and compared the differences using paired t-test. For the evaluation of the degree of change in EF we used linear regression.
Results: The GCSF group had 70 patients and the control group 37. GCSF group did not differ in age (44±14.9 vs. 48.8±17.0, years, p=0.19), beta-blockers (49 vs. 46, %p=0.7), ACE–inhibitors (16 vs. 22, % p=0.46), cardiotoxic chemotherapy (40 vs. 24%p=0.10) or baseline EF (56.2±12.3 vs. 59.7±6.4) when compared with control group. The univariate analysis demonstrates that GCSF group preserve the mean EF; 56.2% and 55.8% p=0.83; vs. control group 59.7% and 55.2% p=0.02. Patients receiving cardiotoxic drugs increased the difference; GCSF group having a EF of 59% and 57.6% p=0.55 vs. control group of 58.3% and 48.8% p=0.04. The beta-coefficient for the change in the difference of EF in the GCSF group, after correcting for demographics, beta blockers and ACEI, was 5.22; 95% C.I 0.56–9.8, p=0.028.
Conclusions: GCSF effect in myocardial function remains controversial; however this study suggest a blunting effect in the remodeling process in patients receiving cardiotoxic drugs, having a protective effect on the myocardium, that require further evaluation.