Granulocyte colony-stimulating factor in allogeneic bone marrow transplantation.
A Phase II study of recombinant granulocyte colony-stimulating factor (G-CSF) in allogeneic bone marrow transplantation (BMT) was performed. The recovery of leukocytes and neutrophils was markedly accelerated in G-CSF-administered recipients. The days to WBC count greater than 1,000/microliters (11.5 +/- 1.9) and the days to neutrophil count greater than 500/microliters (11.5 +/- 1.4) were significantly shorter than those of the monocyte-CSF (M-CSF) and CSF(-) groups. In the G-CSF group the WBC count at nadir was higher than in other groups, and neutrophil recovery preceded monocyte recovery. After the discontinuation of G-CSF, the WBC count first decreased for a few days and then increased again slowly. The short duration of leukopenia brought about a reduction in the number of febrile (greater than 38 degrees C) days which, until day 30, were 1.8 +/- 1.9 in the G-CSF group, also significantly shorter than in others. Acute graft-versus-host disease (greater than grade II) appeared in two of eight patients from the G-CSF group, this incidence being comparable to those found in the other groups. A side effect of G-CSF-mild bone pain-was observed in one patient, but it was tolerable. Six of eight patients in the G-CSF group survived for between five and 13 months after BMT with a Karnofsky score greater than 90%. No relapses were observed in the six, including one patient with chronic myelogenous leukemia and two with acute non-lymphoblastic leukemia. To determine the final influence of G-CSF on myeloid leukemia, further long-term follow-up studies are needed. G-CSF was well tolerated and seemed promising against allogeneic BMT.
Kitayama
H
H
Fifth Department of Internal Medicine, Center for Adult Diseases, Osaka.
Ishikawa
J
J
Yamagami
T
T
Teshima
H
H
Hiraoka
A
A
Nakamura
H
H
Shibata
H
H
Masaoka
T
T
Ishigami
S
S
Takaku
F
F
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D003115:Colony-Stimulating Factors / Q000009:adverse effects / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D005334:Fever / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000453:epidemiology; D016179:Granulocyte Colony-Stimulating Factor; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D010146:Pain / Q000209:etiology; D011014:Pneumonia / Q000517:prevention & control; D012074:Remission Induction; D013280:Stomatitis / Q000517:prevention & control; D015996:Survival Rate
D003115:Colony-Stimulating Factors; D016179:Granulocyte Colony-Stimulating Factor