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Colony stimulating factors.

H G Klingemann¹, C J Eaves

¹Division of Hematology, Cancer Control Agency, British Columbia, Vancouver, Canada.

Bone Marrow Transplantation

|May 1, 1988

Summary

Granulocyte-macrophage colony-stimulating factor (GM-CSF) effectively shortens neutropenia in bone marrow transplant patients. This growth factor enhances neutrophil counts and function, though potential stimulation of malignant cells requires consideration.

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Area of Science:

Hematology
Oncology
Immunology

Background:

Cloning of growth factor genes has enabled clinical trials for hematopoietic and lymphoid cell stimulation.
Erythropoietin, G-CSF, and GM-CSF have shown promising results in Phase I and II studies.

Purpose of the Study:

To evaluate the efficacy and safety of GM-CSF in patients undergoing chemotherapy and bone marrow transplantation (BMT).
To assess the impact of GM-CSF on neutropenia duration and immune cell counts.

Main Methods:

Clinical trials (Phase I/II) involving administration of GM-CSF.
Dose-ranging studies up to 240 micrograms/m2.
Comparison of continuous infusion versus bolus administration.

Main Results:

GM-CSF shortened the period of neutropenia in patients undergoing chemotherapy, including BMT support.
Neutrophil counts increased in a dose-dependent manner; higher doses also increased eosinophils and monocytes.
Continuous infusion was superior to bolus administration for efficacy and reduced side effects.
Enhanced granulocyte and monocyte functions were documented.

Conclusions:

GM-CSF is a well-tolerated and effective therapeutic agent for mitigating neutropenia in cancer patients, particularly those undergoing BMT.
Potential stimulation of malignant cells by G-CSF and GM-CSF is a significant concern in cancer patients with hematopoietic malignancies.

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