title: Activation of lymphocytes induced by recombinant human granulocyte-macrophage colony-stimulating factor in patients with malignant lymphoma.
abstract: To investigate effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on lymphoid cells in vivo, we monitored changes in absolute lymphocyte counts, plasma concentrations of soluble interleukin-2 receptor (sIL-2R) and soluble cytotoxic/suppressor (sCD8) antigens, and phenotypic changes of surface membrane antigens of peripheral mononuclear cells from 14 patients with malignant lymphoma treated with rhGM-CSF. Eight of the 14 patients had relapsed or had refractory non-Hodgkin's lymphoma (NHL) and received rhGM-CSF after intensive chemotherapy with novantrone (NO) and high-dose Ara-C (AC) (NOAC) as salvage regimen. Six other patients with NHL or Hodgkin's disease (HD) were in complete remission and treated with rhGM-CSF to enhance peripheral hematopoietic progenitor cell harvest for autografting. An increase in absolute lymphocyte count at the zenith of leukocyte elevation and a drastic increase in concentration of sIL-2R from a median of 565 U/mL to 6,700 U/mL on rhGM-CSF infusion were found in all patients. There was also a moderate increase in sCD8 levels from a median of 277 U/mL to 470 U/mL. Ten patients were available for serial studies of phenotypic changes in surface membrane antigens. A significant increase in CD25+ (IL-2R+) (P = .0020) and CD4+ (P = .0137) lymphocytes was observed in all patients, but no significant change in CD3+, CD8+, TCR delta 1+, or CD19+ cells. Elevations in absolute lymphocyte counts or in concentrations of sIL-2R or sCD8 were not observed in four other patients during recovery from intensive chemotherapy without rhGM-CSF support. Our results provide evidence that administration of rhGM-CSF might activate lymphocytes in vivo. The impact of this activation on the remission rate and duration, as well as survival in patients with NHL, warrants further investigation.
authors.affiliation: Department of Internal Medicine V and Poliklinik, University of Heidelberg, FRG.
authors.forename: A D
authors.initials: AD
authors.lastname: Ho
authors.forename: R
authors.initials: R
authors.lastname: Haas
authors.forename: G
authors.initials: G
authors.lastname: Wulf
authors.forename: W
authors.initials: W
authors.lastname: Knauf
authors.forename: R
authors.initials: R
authors.lastname: Ehrhardt
authors.forename: B
authors.initials: B
authors.lastname: Heilig
authors.forename: M
authors.initials: M
authors.lastname: Körbling
authors.forename: G
authors.initials: G
authors.lastname: Schulz
authors.forename: W
authors.initials: W
authors.lastname: Hunstein
mesh_terms: D015703:Antigens, CD / Q000032:analysis; D000945:Antigens, Differentiation, T-Lymphocyte / Q000097:blood*; D016827:CD8 Antigens; D003115:Colony-Stimulating Factors / Q000494:pharmacology* / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D006133:Growth Substances / Q000494:pharmacology* / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007167:Immunotherapy; D007958:Leukocyte Count / Q000187:drug effects; D007962:Leukocytes / Q000276:immunology*; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008213:Lymphocyte Activation; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D015375:Receptors, Interleukin-2 / Q000097:blood*; D011994:Recombinant Proteins
chemical_list: D015703:Antigens, CD; D000945:Antigens, Differentiation, T-Lymphocyte; D016827:CD8 Antigens; D003115:Colony-Stimulating Factors; D006133:Growth Substances; D015375:Receptors, Interleukin-2; D011994:Recombinant Proteins; D016178:Granulocyte-Macrophage Colony-Stimulating Factor