GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation Journal Article
| Authors: | Greenberg, P.; Advani, R.; Keating, A.; Gulati, S. C.; Nimer, S.; Champlin, R.; Karanes, C.; Gorin, N. C.; Powles, R. L.; Smith, A.; Lamborn, K.; Cuffie, C. |
| Article Title: | GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation |
| Abstract: | Patients with non-myeloid hematologic malignancies (including Hodgkin's and non-Hodgkin's lymphomas, myeloma and acute lymphoid leukemia) or solid tumors underwent cytoreductive conditioning regimens followed by either autologous bone marrow transplantation (ABMT) (n = 343) or transplantation of peripheral blood stem cells (PBSC) with (n = 44) or without bone marrow (BM) (n = 16). In a randomized doubleblind phase III multi-center trial, patients received either granulocyte-macrophage colony-stimulating factor (GM-CSF, 10 μg/kg/day) or placebo by daily i.v., infusion beginning 24 h after bone marrow infusion and continuing until the absolute neutrophil count (ANC) had recovered to ≤ 1000/mm3, or for a maximum of 30 days. Median time to neutrophil recovery was significantly shorter in the GM-CSF group (18 vs 27 days, P < 0.001), and more GM-CSF patients had neutrophil recovery by day 30 (70 vs 48%). Median duration of hospitalization was significantly shorter in the GM-CSF group (29 vs 32 days, P = 0.02). GM-CSF significantly reduced the median time to neutrophil recovery in patients receiving bone marrow only (19 vs 27 days, P < 0.001) or PBSC with or without bone marrow (14 vs 21 days, P < 0.001). The overall incidence of adverse events was comparable in the two groups, although more patients in the GM-CSF group discontinued treatment due to adverse events (17 vs 9%, P < 0.001). No difference was noted in infection incidence or time to platelet independence. GM-CSF had no negative impact on time to relapse or long-term survival. These data indicate the positive influence of GM-CSF on neutrophil recovery acid hospital stay in patients receiving ABMT for a variety of clinical indications. |
| Keywords: | adolescent; adult; controlled study; treatment outcome; middle aged; survival analysis; major clinical study; clinical trial; neutropenia; salvage therapy; diarrhea; drug efficacy; side effect; solid tumor; edema; controlled clinical trial; drug eruption; infection; thrombocyte; randomized controlled trial; stomatitis; granulocyte macrophage colony stimulating factor; stem cell transplantation; hematopoietic stem cell transplantation; hodgkin disease; fever; hypoalbuminemia; length of stay; nonhodgkin lymphoma; rigor; hematologic neoplasms; neutrophil; peripheral blood stem cell; multicenter study; recombinant proteins; transplantation conditioning; neutrophils; hematopoietic stem cell; acute lymphocytic leukemia; bone marrow transplantation; double blind procedure; double-blind method; transplantation, autologous; intravenous drug administration; cell transplantation; myeloma; autologous bone marrow transplantation; gm-csf; autotransplantation; granulocyte-macrophage colony-stimulating factor; bmt; life tables; humans; human; male; female; priority journal; article |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 18 |
| Issue: | 6 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 1996-12-01 |
| Start Page: | 1057 |
| End Page: | 1064 |
| Language: | English |
| PUBMED: | 8971373 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Source: Scopus |
