Use of G-CSF to hasten neutrophil recovery after auto-SCT for AML is not associated with increased relapse incidence: a report from the Acute Leukemia Working Party of the EBMT

Application of G-CSF in AML is controversial as leukemic blasts may express receptors interacting with the cytokine, which may stimulate leukemia growth. We retrospectively analyzed the impact of G-CSF use to accelerate neutrophil recovery after auto-SCT on outcome. Adults with AML in first CR autografted between 1994 and 2010 were included. Nine hundred and seventy two patients were treated with G-CSF after auto-SCT whereas 1121 were not. BM and PB were used as a source of stem cells in 454 (22%) and 1639 (78%) cases, respectively. The incidence of relapse at 5 years in the BM-auto-SCT group was 38% for patients receiving post-transplant G-CSF and 43% for those not treated with G-CSF, P=0.46. In the PB-auto-SCT cohort, respective probabilities were 48% and 49%, P=0.49. No impact of the use of G-CSF could be demonstrated with respect to the probability of leukemia-free survival: in the BM-auto-SCT group, 51% for G-CSF(+) and 48% for G-CSF(-), P=0.73; in PB-auto-SCT group, 42% for G-CSF(+) and 43% for G-CSF(-), P=0.83. Although G-CSF administration significantly shortened the neutropenic phase, no beneficial effect was observed with regard to non-relapse mortality. In patients with AML, the use of G-CSF after auto-SCT is not associated with increased risk of relapse irrespective of the source of stem cells used.

Vicarious gastric excretion of intravenous contrast

Radiographic identification of vicarious excretion of intravenous contrast into the stomach has not previously been cited in the literature. We report here an instance of gastric excretion of iodinated intravenous contrast following excretory urography in a severely burned patient. The physiology and possible pathways of vicarious excretion of contrast are discussed.

Leiomyoma involving the gastrocolic ligament: CT demonstration

A case of a large leiomyoma involving both the transverse colon and the greater curvature of the stomach is presented. Computed tomography (CT) demonstrated contiguous extension of the mass along the gastrocolic ligament. Although similar findings have been described in colonic and gastric carcinoma and in omental metastases, this is the first report in which these findings were due to a leiomyoma.