title: rhGM-CSF ameliorates neutropenia in patients with malignant glioma treated with BCNU.
abstract: Nitrosoureas are the drugs most effective in the treatment of patients with intracerebral malignant glioma. Their limiting toxicity is delayed myelosuppression. A prospective, randomised crossover study of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was performed in patients receiving BCNU for relapsed glioblastoma, to investigate whether the resulting haematological toxicity profile could be modified by rhGM-CSF. Adequate data for analysis were obtained in 13 patients. Following BCNU, the nadir neutrophil count was higher in 12 out of 13 patients during the rhGM-CSF-protected cycles compared with the unprotected cycles. The median nadir was also significantly higher (1.79, CI 0.76-3.52, P < 0.005). Five episodes of neutropenia (< 2 x 10(9) l-1) occurred during the unprotected cycles compared with none in the rhGM-CSF-protected cycles (P = 0.076). There was no evidence of any effect on platelets. This result shows that the haematological toxicity profile following therapeutic doses of BCNU can be modified. It suggests that rhGM-CSF and other growth factors should be investigated for clinical efficacy in chemotherapy using nitrosoureas.
authors.affiliation: Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
authors.forename: R
authors.initials: R
authors.lastname: Rampling
authors.forename: W
authors.initials: W
authors.lastname: Steward
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.forename: M A
authors.initials: MA
authors.lastname: Macham
authors.forename: E
authors.initials: E
authors.lastname: Harvey
authors.forename: D
authors.initials: D
authors.lastname: Eckley
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy*; D002330:Carmustine / Q000627:therapeutic use / Q000633:toxicity*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy*; D005910:Glioma / Q000188:drug therapy*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy*; D009504:Neutrophils / Q000187:drug effects; D010976:Platelet Count / Q000187:drug effects; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D002330:Carmustine