Combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (EPO) for the treatment of advanced non-responsive chronic lymphocytic leukemia

Filippo Russo, Stefano Guadagni, Gioacchino Mattera, Giuseppe Esposito, Giuseppe Abate

Research output: Contribution to journalArticle

Abstract

We report the use of a colony-stimulating granulocyte-macrophage factor (GM/CSF) and erythropoietin (EPO) combination as salvage treatment in four heavily-pretreated patients with refractory/recurrent B-CLL. Induction therapy was subcutaneous GM-CSF 2.5 μg/kg, and EPO, 150 units/kg both daily for the first 14 d. Maintenance therapy was GM-CSF on days 1, 3 and 5 and Epo on days 2, 4 and 6 at the same doses with weekly recycling. All the patients responded favourably. A significant reduction of lymphocytosis, lymphoadenomegaly, and organomegaly was obtained within one month of therapy. The number of infections and transfusional requirement decreased dramatically. The hemoglobin increased to over 11 g/dl in 3 out of 4 patients. With a median follow-up of 11 months (range 5-13) we observed 4 partial responses (NCI/IWCLL) and only one progression after a 10-month partial response. This combination regimen seems very active, safe and easy to administer. It may represent a promising therapeutical option in heavily pretreated patients. Further clinical and biological studies on a larger cohort of patients are needed to confirm these preliminary data, to clarify the hypothetical interactions between these cytokines and B-CLL cell proliferation pathways, and to establish if this therapy may have an impact on survival.

Original languageEnglish
Pages (from-to)325-331
Number of pages7
JournalEuropean Journal of Haematology
Volume63
Issue number5
Publication statusPublished - 1999

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B-Cell Chronic Lymphocytic Leukemia
Granulocyte-Macrophage Colony-Stimulating Factor
Erythropoietin
Therapeutics
Lymphocytosis
Salvage Therapy
Recycling
Hemoglobins
Cell Proliferation
Cytokines
Survival
Infection

Keywords

  • Chronic lymphocytic leukemia
  • Erythropoietin
  • GM- CSF
  • Refractory disease
  • Salvage therapy

ASJC Scopus subject areas

  • Hematology

Cite this

Combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (EPO) for the treatment of advanced non-responsive chronic lymphocytic leukemia. / Russo, Filippo; Guadagni, Stefano; Mattera, Gioacchino; Esposito, Giuseppe; Abate, Giuseppe.

In: European Journal of Haematology, Vol. 63, No. 5, 1999, p. 325-331.

Research output: Contribution to journalArticle

Russo, Filippo ; Guadagni, Stefano ; Mattera, Gioacchino ; Esposito, Giuseppe ; Abate, Giuseppe. / Combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (EPO) for the treatment of advanced non-responsive chronic lymphocytic leukemia. In: European Journal of Haematology. 1999 ; Vol. 63, No. 5. pp. 325-331.
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