Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation

S. J. Brandt, W. P. Peters, S. K. Atwater, J. Kurtzberg, Michael J Borowitz, R. B. Jones, J. Shpall, R. C. Bast, C. J. Gilbert, D. H. Oette

Research output: Contribution to journalArticle

Abstract

Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) has been reported to increase the leukocyte count in subhuman primates subjected to total-body irradiation and in patients with the acquired immunodeficiency syndrome. We administered this substance to 19 patients with breast cancer or melanoma treated with high-dose combination chemotherapy and autologous bone marrow support. Groups of three or four patients were treated with 2.0, 4.0, 8.0, 16.0, or 32.0 μg per kilogram of body weight per day of glycosylated rHuGM-CSF by continuous intravenous infusion for 14 days, beginning three hours after bone marrow infusion. Total leukocyte and granulocyte recovery was accelerated in these patients as compared with 24 historical controls matched for age, diagnosis, and treatment. Leukocyte counts (mean ± SD) obtained 14 days after transplantation were 1511 ± 1003 per microliter in patients given 2 to 8 μg per kilogram per day, 2575 ± 2304 in those given 16 ♂g, and 3120 ± 1744 in those given 32 μg, as compared with 863 ± 645 per microliter in the controls. No consistent effect on platelet counts was noted. Toxic effects were generally mild and not clearly dose-related in patients given 2 to 16 μg per kilogram per day. Edema, weight gain, or myalgias occurred in all patients given 32 μg per kilogram; marked weight gain, generalized edema, pleural effusions, and hypotension developed in two patients, one of whom also had acute renal failure. Our results indicate that rHuGM-CSF can accelerate myeloid recovery after high-dose chemotherapy and autologous bone marrow transplantation, over a range of doses that can be tolerated. In this setting the ability to increase the dose is limited by the development of myalgias and fluid retention.

Original languageEnglish (US)
Pages (from-to)869-876
Number of pages8
JournalNew England Journal of Medicine
Volume318
Issue number14
StatePublished - 1988
Externally publishedYes

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Autologous Transplantation
Granulocyte-Macrophage Colony-Stimulating Factor
Bone Marrow Transplantation
Drug Therapy
Myalgia
Leukocyte Count
Weight Gain
Edema
Bone Marrow
Aptitude
Whole-Body Irradiation
Poisons
Pleural Effusion
Combination Drug Therapy
Platelet Count
Acute Kidney Injury
Granulocytes
Intravenous Infusions
Hypotension
Primates

ASJC Scopus subject areas

  • Medicine(all)

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Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. / Brandt, S. J.; Peters, W. P.; Atwater, S. K.; Kurtzberg, J.; Borowitz, Michael J; Jones, R. B.; Shpall, J.; Bast, R. C.; Gilbert, C. J.; Oette, D. H.

In: New England Journal of Medicine, Vol. 318, No. 14, 1988, p. 869-876.

Research output: Contribution to journalArticle

Brandt, S. J. ; Peters, W. P. ; Atwater, S. K. ; Kurtzberg, J. ; Borowitz, Michael J ; Jones, R. B. ; Shpall, J. ; Bast, R. C. ; Gilbert, C. J. ; Oette, D. H. / Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. In: New England Journal of Medicine. 1988 ; Vol. 318, No. 14. pp. 869-876.
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AU - Peters, W. P.

AU - Atwater, S. K.

AU - Kurtzberg, J.

AU - Borowitz, Michael J

AU - Jones, R. B.

AU - Shpall, J.

AU - Bast, R. C.

AU - Gilbert, C. J.

AU - Oette, D. H.

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