title: Use of granulocyte-macrophage colony-stimulating factor in patients with malignancy and bone marrow failure.
abstract: Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) was administered to 10 patients with refractory malignancies, 2 patients who had myelodysplastic syndromes with severe neutropenia and to a patient who had delayed marrow recovery after 3 cycles of therapy for acute leukemia. A marked neutropenia and monocytopenia was observed within 5 min after an i.v. injection of GM-CSF. This persisted for 1-2 h and seemed related to activation of an adhesive glycoprotein (MO1) on the surface of these cells. With continued daily i.v. administration of GM-CSF, all patients with refractory malignancies developed a striking leukocytosis. Total leukocyte counts reached 75,000/microliters within 2 weeks of treatment. This was due to an increase in band and segmented neutrophils, eosinophils and monocytes. Accelerated myelopoiesis required the continuous presence of GM-CSF; with pump failure for 24 h or discontinuation after 14 days, leukocyte counts returned to normal levels in 24-48 h. GM-CSF also increased myelopoiesis in the patients with myelodysplastic syndromes or following anti-leukemic treatment. These observations suggest that this growth factor should prove a useful adjunct in the treatment of patients with malignancies and bone marrow failure.
authors.affiliation: Pittsburgh Cancer Institute, Pennsylvania.
authors.forename: R K
authors.initials: RK
authors.lastname: Shadduck
authors.forename: C S
authors.initials: CS
authors.lastname: Rosenfeld
authors.forename: M
authors.initials: M
authors.lastname: Sulecki
authors.forename: N
authors.initials: N
authors.lastname: Phillips
authors.forename: D
authors.initials: D
authors.lastname: Przepiorka
authors.forename: M
authors.initials: M
authors.lastname: Earle
authors.forename: R
authors.initials: R
authors.lastname: Stoller
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
mesh_terms: D000368:Aged; D003115:Colony-Stimulating Factors / Q000627:therapeutic use*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D009504:Neutrophils / Q000187:drug effects
chemical_list: D003115:Colony-Stimulating Factors; D006133:Growth Substances; D016178:Granulocyte-Macrophage Colony-Stimulating Factor