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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.

Publication ,  Journal Article
Brandt, SJ; Peters, WP; Atwater, SK; Kurtzberg, J; Borowitz, MJ; Jones, RB; Shpall, EJ; Bast, RC; Gilbert, CJ; Oette, DH
Published in: N Engl J Med
April 7, 1988

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 micrograms 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 micrograms per kilogram per day, 2575 +/- 2304 in those given 16 micrograms, and 3120 +/- 1744 in those given 32 micrograms, 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 micrograms per kilogram per day. Edema, weight gain, or myalgias occurred in all patients given 32 micrograms 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.

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Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

April 7, 1988

Volume

318

Issue

14

Start / End Page

869 / 876

Location

United States

Related Subject Headings

  • Recombinant Proteins
  • Platelet Count
  • Middle Aged
  • Melanoma
  • Leukocyte Count
  • Humans
  • Hematopoiesis
  • Growth Substances
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • General & Internal Medicine
 

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Brandt, S. J., Peters, W. P., Atwater, S. K., Kurtzberg, J., Borowitz, M. J., Jones, R. B., … Oette, D. H. (1988). Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. N Engl J Med, 318(14), 869–876. https://doi.org/10.1056/NEJM198804073181401
Brandt, S. J., W. P. Peters, S. K. Atwater, J. Kurtzberg, M. J. Borowitz, R. B. Jones, E. J. Shpall, R. C. Bast, C. J. Gilbert, and D. H. Oette. “Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation.N Engl J Med 318, no. 14 (April 7, 1988): 869–76. https://doi.org/10.1056/NEJM198804073181401.
Brandt, S. J., et al. “Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation.N Engl J Med, vol. 318, no. 14, Apr. 1988, pp. 869–76. Pubmed, doi:10.1056/NEJM198804073181401.
Brandt SJ, Peters WP, Atwater SK, Kurtzberg J, Borowitz MJ, Jones RB, Shpall EJ, Bast RC, Gilbert CJ, Oette DH. Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. N Engl J Med. 1988 Apr 7;318(14):869–876.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

April 7, 1988

Volume

318

Issue

14

Start / End Page

869 / 876

Location

United States

Related Subject Headings

  • Recombinant Proteins
  • Platelet Count
  • Middle Aged
  • Melanoma
  • Leukocyte Count
  • Humans
  • Hematopoiesis
  • Growth Substances
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • General & Internal Medicine