Use of recombinant human granulocyte-macrophage colony-stimulating factor in graft failure after bone marrow transplantation.
The effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was evaluated in 37 patients with marrow graft failure after allogeneic (n = 15), autologous (n = 21), or syngeneic (n = 1) bone marrow transplantation. rhGM-CSF was administered by 2-hour infusion at doses between 60 and 1,000 micrograms/m2/d for 14 or 21 days. At doses of less than 500 micrograms/m2, rhGM-CSF was well-tolerated and did not exacerbate graft-versus-host disease in allogeneic transplant recipients. No patient with myelogenous leukemia relapsed while receiving rhGM-CSF. Twenty-one patients reached an absolute neutrophil count (ANC) greater than or equal to 0.5 x 10(9)/L within 2 weeks of starting therapy while 16 did not. None of seven patients who received chemically purged autologous marrow grafts responded to rhGM-CSF. The survival rates of GM-CSF-treated patients were significantly better than those of a historical control group.
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA.
J
J
Nemunaitis
J W
JW
Singer
C D
CD
Buckner
D
D
Durnam
C
C
Epstein
R
R
Hill
R
R
Storb
E D
ED
Thomas
F R
FR
Appelbaum
D000293:Adolescent; D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000187:drug effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003115:Colony-Stimulating Factors / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D003520:Cyclophosphamide / Q000031:analogs & derivatives / Q000494:pharmacology; D005047:Etoposide / Q000494:pharmacology; D005260:Female; D006084:Graft Rejection / Q000187:drug effects; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000401:mortality; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D006133:Growth Substances / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D006410:Hematopoiesis / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects
D003115:Colony-Stimulating Factors; D006133:Growth Substances; D011994:Recombinant Proteins; D005047:Etoposide; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D003520:Cyclophosphamide; C011272:perfosfamide