The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism

Ahmet Gurakar, Stefano Fagiuoli, Judith S. Gavaler, Tarek Hassanein, Nicholas Jabbour, Harlon I. Wright, Steven A. Deal, Ashot Shah, Manuel Brown, Brian I. Carr, Daniel H. Van Thiel

Research output: Contribution to journalArticle

Abstract

In patients with end-stage liver disease complicated with hypersplenism, neutropenia and thrombocytopenia are risk factors for systemic sepsis and spontaneous bleeding. Granulocyte-macrophage colony-stimulating factor is a naturally occurring cytokine that promotes proliferation and differentiation of granulocyte and monocyte progeny cells. In addition, it is reported to promote the proliferation of megakaryocytes. Its use as an intravenous infusion is Federal Drug Authority (USA) approved for the enhancement of myeloid recovery following autologous bone-marrow transplantation. The present study was initiated to determine whether granulocyte-macrophage colony-stimulating factor could be used to increase the white blood cell and platelet count in patients with cirrhosis and hypersplenism and to determine whether the more convenient subcutaneous route can be used with the same efficacy as the recommended intravenous route. Nine patients with cirrhosis and hypersplenism manifested by a reduced absolute neutrophil count (mean value of 1300±200/mm3) were studied. In eight patients, Indium white blood cell splenic sequestration scans were obtained before and after the administration of granulocyte-macrophage colony-stimulating factor intravenous infusion or subcutaneously for 7 days. One patient had to discontinue the therapy due to a reaction to granulocyte-macrophage colony-stimulating factor. Following intravenous infusion of granulocyte-macrophage colony-stimulating factor, the mean absolute neutrophil count increased to 2600±1100/mm3. Following subcutaneous administration, the mean absolute neutrophil count increased to 4100±200/mm3. No significant change in platelet count occurred with either route of administration. Indium scans obtained before and after the treatment period revealed no significant difference in the splenic uptake. Based upon these data, it can be concluded that: 1) Granulocyte-macrophage colony-stimulating factor can be used to increase the white blood cells and the absolute neutrophil count, but not the platelet count of patients with cirrhosis and hyper-splenism; 2) The more convenient subcutaneous route is as efficient as the Federal Drug Authority (USA) approved intravenous route; and 3) No change in the fraction of white blood cells sequestered in the spleen was observed following granulocyte-macrophage colony-stimulating factor administration.

Original languageEnglish (US)
Pages (from-to)582-586
Number of pages5
JournalJournal of Hepatology
Volume21
Issue number4
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Hypersplenism
Granulocyte-Macrophage Colony-Stimulating Factor
Fibrosis
Neutrophils
Platelet Count
Intravenous Infusions
Indium
Leukocytes
End Stage Liver Disease
Megakaryocytes
Autologous Transplantation
Neutropenia
Bone Marrow Transplantation
Leukocyte Count
Granulocytes
Thrombocytopenia
Pharmaceutical Preparations
Monocytes
Sepsis
Spleen

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism. / Gurakar, Ahmet; Fagiuoli, Stefano; Gavaler, Judith S.; Hassanein, Tarek; Jabbour, Nicholas; Wright, Harlon I.; Deal, Steven A.; Shah, Ashot; Brown, Manuel; Carr, Brian I.; Van Thiel, Daniel H.

In: Journal of Hepatology, Vol. 21, No. 4, 1994, p. 582-586.

Research output: Contribution to journalArticle

Gurakar, A, Fagiuoli, S, Gavaler, JS, Hassanein, T, Jabbour, N, Wright, HI, Deal, SA, Shah, A, Brown, M, Carr, BI & Van Thiel, DH 1994, 'The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism', Journal of Hepatology, vol. 21, no. 4, pp. 582-586. https://doi.org/10.1016/S0168-8278(94)80105-3
Gurakar, Ahmet ; Fagiuoli, Stefano ; Gavaler, Judith S. ; Hassanein, Tarek ; Jabbour, Nicholas ; Wright, Harlon I. ; Deal, Steven A. ; Shah, Ashot ; Brown, Manuel ; Carr, Brian I. ; Van Thiel, Daniel H. / The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism. In: Journal of Hepatology. 1994 ; Vol. 21, No. 4. pp. 582-586.
@article{5e5d67c8a2f5461a93ae5c0161a30bf9,
title = "The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism",
abstract = "In patients with end-stage liver disease complicated with hypersplenism, neutropenia and thrombocytopenia are risk factors for systemic sepsis and spontaneous bleeding. Granulocyte-macrophage colony-stimulating factor is a naturally occurring cytokine that promotes proliferation and differentiation of granulocyte and monocyte progeny cells. In addition, it is reported to promote the proliferation of megakaryocytes. Its use as an intravenous infusion is Federal Drug Authority (USA) approved for the enhancement of myeloid recovery following autologous bone-marrow transplantation. The present study was initiated to determine whether granulocyte-macrophage colony-stimulating factor could be used to increase the white blood cell and platelet count in patients with cirrhosis and hypersplenism and to determine whether the more convenient subcutaneous route can be used with the same efficacy as the recommended intravenous route. Nine patients with cirrhosis and hypersplenism manifested by a reduced absolute neutrophil count (mean value of 1300±200/mm3) were studied. In eight patients, Indium white blood cell splenic sequestration scans were obtained before and after the administration of granulocyte-macrophage colony-stimulating factor intravenous infusion or subcutaneously for 7 days. One patient had to discontinue the therapy due to a reaction to granulocyte-macrophage colony-stimulating factor. Following intravenous infusion of granulocyte-macrophage colony-stimulating factor, the mean absolute neutrophil count increased to 2600±1100/mm3. Following subcutaneous administration, the mean absolute neutrophil count increased to 4100±200/mm3. No significant change in platelet count occurred with either route of administration. Indium scans obtained before and after the treatment period revealed no significant difference in the splenic uptake. Based upon these data, it can be concluded that: 1) Granulocyte-macrophage colony-stimulating factor can be used to increase the white blood cells and the absolute neutrophil count, but not the platelet count of patients with cirrhosis and hyper-splenism; 2) The more convenient subcutaneous route is as efficient as the Federal Drug Authority (USA) approved intravenous route; and 3) No change in the fraction of white blood cells sequestered in the spleen was observed following granulocyte-macrophage colony-stimulating factor administration.",
author = "Ahmet Gurakar and Stefano Fagiuoli and Gavaler, {Judith S.} and Tarek Hassanein and Nicholas Jabbour and Wright, {Harlon I.} and Deal, {Steven A.} and Ashot Shah and Manuel Brown and Carr, {Brian I.} and {Van Thiel}, {Daniel H.}",
year = "1994",
doi = "10.1016/S0168-8278(94)80105-3",
language = "English (US)",
volume = "21",
pages = "582--586",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - The use of granulocyte-macrophage colony-stimulating factor to enhance hematologic parameters of patients with cirrhosis and hypersplenism

AU - Gurakar, Ahmet

AU - Fagiuoli, Stefano

AU - Gavaler, Judith S.

AU - Hassanein, Tarek

AU - Jabbour, Nicholas

AU - Wright, Harlon I.

AU - Deal, Steven A.

AU - Shah, Ashot

AU - Brown, Manuel

AU - Carr, Brian I.

AU - Van Thiel, Daniel H.

PY - 1994

Y1 - 1994

N2 - In patients with end-stage liver disease complicated with hypersplenism, neutropenia and thrombocytopenia are risk factors for systemic sepsis and spontaneous bleeding. Granulocyte-macrophage colony-stimulating factor is a naturally occurring cytokine that promotes proliferation and differentiation of granulocyte and monocyte progeny cells. In addition, it is reported to promote the proliferation of megakaryocytes. Its use as an intravenous infusion is Federal Drug Authority (USA) approved for the enhancement of myeloid recovery following autologous bone-marrow transplantation. The present study was initiated to determine whether granulocyte-macrophage colony-stimulating factor could be used to increase the white blood cell and platelet count in patients with cirrhosis and hypersplenism and to determine whether the more convenient subcutaneous route can be used with the same efficacy as the recommended intravenous route. Nine patients with cirrhosis and hypersplenism manifested by a reduced absolute neutrophil count (mean value of 1300±200/mm3) were studied. In eight patients, Indium white blood cell splenic sequestration scans were obtained before and after the administration of granulocyte-macrophage colony-stimulating factor intravenous infusion or subcutaneously for 7 days. One patient had to discontinue the therapy due to a reaction to granulocyte-macrophage colony-stimulating factor. Following intravenous infusion of granulocyte-macrophage colony-stimulating factor, the mean absolute neutrophil count increased to 2600±1100/mm3. Following subcutaneous administration, the mean absolute neutrophil count increased to 4100±200/mm3. No significant change in platelet count occurred with either route of administration. Indium scans obtained before and after the treatment period revealed no significant difference in the splenic uptake. Based upon these data, it can be concluded that: 1) Granulocyte-macrophage colony-stimulating factor can be used to increase the white blood cells and the absolute neutrophil count, but not the platelet count of patients with cirrhosis and hyper-splenism; 2) The more convenient subcutaneous route is as efficient as the Federal Drug Authority (USA) approved intravenous route; and 3) No change in the fraction of white blood cells sequestered in the spleen was observed following granulocyte-macrophage colony-stimulating factor administration.

AB - In patients with end-stage liver disease complicated with hypersplenism, neutropenia and thrombocytopenia are risk factors for systemic sepsis and spontaneous bleeding. Granulocyte-macrophage colony-stimulating factor is a naturally occurring cytokine that promotes proliferation and differentiation of granulocyte and monocyte progeny cells. In addition, it is reported to promote the proliferation of megakaryocytes. Its use as an intravenous infusion is Federal Drug Authority (USA) approved for the enhancement of myeloid recovery following autologous bone-marrow transplantation. The present study was initiated to determine whether granulocyte-macrophage colony-stimulating factor could be used to increase the white blood cell and platelet count in patients with cirrhosis and hypersplenism and to determine whether the more convenient subcutaneous route can be used with the same efficacy as the recommended intravenous route. Nine patients with cirrhosis and hypersplenism manifested by a reduced absolute neutrophil count (mean value of 1300±200/mm3) were studied. In eight patients, Indium white blood cell splenic sequestration scans were obtained before and after the administration of granulocyte-macrophage colony-stimulating factor intravenous infusion or subcutaneously for 7 days. One patient had to discontinue the therapy due to a reaction to granulocyte-macrophage colony-stimulating factor. Following intravenous infusion of granulocyte-macrophage colony-stimulating factor, the mean absolute neutrophil count increased to 2600±1100/mm3. Following subcutaneous administration, the mean absolute neutrophil count increased to 4100±200/mm3. No significant change in platelet count occurred with either route of administration. Indium scans obtained before and after the treatment period revealed no significant difference in the splenic uptake. Based upon these data, it can be concluded that: 1) Granulocyte-macrophage colony-stimulating factor can be used to increase the white blood cells and the absolute neutrophil count, but not the platelet count of patients with cirrhosis and hyper-splenism; 2) The more convenient subcutaneous route is as efficient as the Federal Drug Authority (USA) approved intravenous route; and 3) No change in the fraction of white blood cells sequestered in the spleen was observed following granulocyte-macrophage colony-stimulating factor administration.

UR - http://www.scopus.com/inward/record.url?scp=0027998130&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027998130&partnerID=8YFLogxK

U2 - 10.1016/S0168-8278(94)80105-3

DO - 10.1016/S0168-8278(94)80105-3

M3 - Article

C2 - 7814805

AN - SCOPUS:0027998130

VL - 21

SP - 582

EP - 586

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 4

ER -