title: Granulocyte-macrophage colony-stimulating factor as infection prophylaxis in high-risk oncologic surgery.
abstract: BACKGROUND
  A method of augmenting host defenses against bacterial pathogens could result in a decrease in postoperative infections. Given its effects on leukocyte proliferation and function, it is possible that prophylactic granulocyte-macrophage colony-stimulating factor (GM-CSF) could reduce the incidence and severity of infections in high-risk surgical patients. The current study was undertaken to determine the safety and hematologic effects of perioperative GM-CSF.
  
  
  METHODS
  Cancer patients undergoing operations with a high risk of postoperative infection were treated perioperatively for 10 days with subcutaneous GM-CSF. Cohorts were treated with GM-CSF at 125 micrograms/m2/day (12 patients) and 250 micrograms/m2/day (11 patients).
  
  
  RESULTS
  There were no severe or life-threatening toxicities associated with GM-CSF. Mean maximum neutrophil counts during the first 5 postoperative days were 16.3 +/- 9.14 and 24.5 +/- 7.60 at 125 and 250 micrograms/m2, respectively (P = 0.04). Only one wound infection was diagnosed during this study.
  
  
  CONCLUSIONS
  GM-CSF may be safely administered perioperatively at doses that augment neutrophil number and function. An ongoing randomized clinical trial will determine the impact of GM-CSF on postoperative infection.
authors.affiliation: Division of Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Meropol
authors.forename: N J
authors.initials: NJ
authors.lastname: Petrelli
authors.forename: B J
authors.initials: BJ
authors.lastname: Lipman
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez-Bigas
authors.forename: W
authors.initials: W
authors.lastname: Hicks
authors.forename: H O
authors.initials: HO
authors.lastname: Douglass
authors.forename: J L
authors.initials: JL
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Rasey
authors.forename: L E
authors.initials: LE
authors.lastname: Blumenson
authors.forename: L
authors.initials: L
authors.lastname: Vaickus
authors.forename: F A
authors.initials: FA
authors.lastname: Hayes
authors.forename: J M
authors.initials: JM
authors.lastname: Agosti
mesh_terms: D001424:Bacterial Infections / Q000517:prevention & control*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D012307:Risk Factors
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor