Although granulocyte colony-stimulating factor (G-CSF) reduces the incidence, duration, and severity of neutropenia, its prophylactic use for acute myeloid leukemia (AML) remains controversial due to a theoretically increased risk of relapse. The present study investigated the effects of G-CSF as primary prophylaxis for AML with remission induction therapy. A detailed literature search for related studies was performed using PubMed, Ichushi-Web, and the Cochrane Library. Data were independently extracted and assessed by two reviewers. A qualitative analysis of pooled data was conducted, and the risk ratio with corresponding confidence intervals was calculated in the meta-analysis and summarized. Sixteen studies were included in the qualitative analysis, nine of which were examined in the meta-analysis. Although G-CSF significantly shortened the duration of neutropenia, primary prophylaxis with G-CSF did not correlate with infection-related mortality. Moreover, primary prophylaxis with G-CSF did not affect disease progression/recurrence, overall survival, or adverse events, such as musculoskeletal pain. However, evidence to support or discourage the use of G-CSF as primary prophylaxis for adult AML patients with induction therapy remains limited. Therefore, the use of G-CSF as primary prophylaxis can be considered for adult AML patients with remission induction therapy who are at a high risk of infectious complications.

尽管粒细胞集落刺激因子 (G-CSF) 可以降低中性粒细胞减少症的发生率、持续时间和严重程度，但由于理论上会增加复发风险，因此其预防性使用急性髓系白血病 (AML) 仍存在争议。本研究调查了 G-CSF 作为 AML 一级预防和缓解诱导治疗的效果。使用 PubMed、Ichushi-Web 和 Cochrane 图书馆对相关研究进行了详细的文献检索。数据由两名评审员独立提取和评估。对汇总数据进行定性分析，并在荟萃分析中计算风险比和相应的置信区间并进行总结。定性分析中纳入了十六项研究，其中九项在荟萃分析中进行了检查。尽管 G-CSF 显着缩短了中性粒细胞减少症的持续时间，但 G-CSF 的一级预防与感染相关死亡率无关。此外，G-CSF 的一级预防不会影响疾病进展/复发、总体生存或不良事件，例如肌肉骨骼疼痛。然而，支持或反对使用 G-CSF 作为诱导治疗的成人 AML 患者的一级预防的证据仍然有限。因此，对于感染性并发症风险较高的接受缓解诱导治疗的成人 AML 患者，可以考虑使用 G-CSF 作为一级预防。