Unexpected hepatotoxicity after priming and treatment with molgramostim (rhGM-CSF) in acute myeloid leukemia during induction chemotherapy.
The effect of supplementing induction chemotherapy with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was studied in a randomized trial of 18 patients with acute myeloid leukemia (AML). Ten patients received rhGM-CSF, starting on day one to three before chemotherapy and continued for a maximum of 21 days after the start of induction treatment. Unexpected adverse effects of rhGM-CSF and chemotherapy combination included a transient decline in plasma coagulation factors II, VII, and X (5 of 5 patients) and an increased transcapillary escape rate of albumin (in 3 of 3 patients tested). The decline in coagulation factors was prevented in subsequent patients by prophylactic treatment with vitamin K. Although the small number of patients studied may not allow a definite conclusion, caution with regard to liver function should be shown in combining rhGM-CSF with intensive chemotherapy.
Department of Hematology L. Herlev Hospital, University of Copenhagen, Denmark.
P B
PB
Hansen
H E
HE
Johnsen
J O
JO
Lund
M S
MS
Hansen
N E
NE
Hansen
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001779:Blood Coagulation Factors / Q000187:drug effects; D056486:Chemical and Drug Induced Liver Injury; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects; D012074:Remission Induction
D000970:Antineoplastic Agents; D001779:Blood Coagulation Factors; D011994:Recombinant Proteins; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; C082430:molgramostim