Granulocyte-macrophage colony-stimulating factor in acute non-lymphocytic leukemia before and after chemotherapy

G. Visani, D. Damiani, A. Cenacchi, D. Russo, G. Revignas, B. Gamberi, R. Fanin, M. Fogli, M. Baccarani, S. Tura

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Abstract

The introduction of hematopoietic growth factors into the management of leukemia can influence the outcome of treatment in several ways, depending on the sensitivity and the response of normal and leukemic cells. In this paper we report on the effects of the administration of Escherichia coli-produced, human recombinant granulocyte-macrophage colony-stimulating factor (GMCSF) in 15 adult patients with acute nonlymphocytic leukemia (ANLL) resistant to first-line treatment or in relapse. GM-CSF was given at a dose of 5-10 μg/kg/day as a 6-h i.v. infusion, prior to chemotherapy (CHT) (for 7 days) and after CHT (until evidence of failure or of remission). In the pre-CHT period there was a clear trend towards an increase of circulating neutrophils (PMN) and/or blast cell count (median 0.3 vs. 1.0×109/l for PMN, and 0.5 vs. 2.3 for blast cells). After chemotherapy, in the patients who achieved complete remission (CR), the median time to a PMN count > 0.5×109/l and > 1×109/l was 16 days (range 13-27) and 19 days (range 13-42) respectively. The outcome of treatment was CR for 8/15 (53%), death during induction for 3/15 (20%), and failure for 4/15 (27%). All failures occurred in patients with an increase of blast cell count during pre-CHT GM-CSF administration. Toxicity and side effects were minor, apart from an acute respiratory syndrome that developed twice in the same patient, at doses of 10 and 3 μg/kg/day. These data suggest that investigation of GM-CSF in the treatment of ANLL is worth pursuing, with special attention to GM-CSF effects prior to chemotherapy.

Original languageEnglish
Pages (from-to)276-281
Number of pages6
JournalAnnals of Hematology
Volume63
Issue number5
DOIs
Publication statusPublished - Nov 1991

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Keywords

  • Chemotherapy
  • GM-CSF
  • Growth factors
  • Leukemia

ASJC Scopus subject areas

  • Hematology

Cite this

Visani, G., Damiani, D., Cenacchi, A., Russo, D., Revignas, G., Gamberi, B., Fanin, R., Fogli, M., Baccarani, M., & Tura, S. (1991). Granulocyte-macrophage colony-stimulating factor in acute non-lymphocytic leukemia before and after chemotherapy. Annals of Hematology, 63(5), 276-281. https://doi.org/10.1007/BF01698378