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Granulocyte-macrophage colony stimulating factor (rh-GM-CSF) in the treatment of chemotherapy-induced neutropenia
S Gözdasoglu1, E Unal, G Yavuz
1Department of Pediatrics, University of Ankara School of Medicine, Turkey.
Insights
Recombinant granulocyte-macrophage colony stimulating factor (rh-GM-CSF) effectively accelerated hematopoietic recovery in pediatric cancer patients undergoing chemotherapy. This treatment demonstrated good tolerance, supporting its use in intensive pediatric cancer treatment regimens.
Area of Science:
- Pediatric Oncology
- Hematology
- Pharmacology
Background:
- Neutropenia is a common side effect of chemotherapy in pediatric cancer patients.
- Recombinant granulocyte-macrophage colony stimulating factor (rh-GM-CSF) is a therapeutic agent aimed at stimulating white blood cell production.
Purpose of the Study:
- To evaluate the efficacy and safety of rh-GM-CSF in pediatric patients with solid tumors and malignant lymphomas experiencing neutropenia.
- To assess the impact of rh-GM-CSF on hematopoietic recovery time during intensive chemotherapy.
Main Methods:
- Eleven pediatric patients with various cancers received rh-GM-CSF (5 micrograms/kg daily) for seven days.
- Treatment initiation was either post-chemotherapy or when absolute neutrophil count (ANC) fell below 1000/ml.
- Patients had solid tumors or lympho-reticular malignancies.
Main Results:
- Hematopoietic recovery was observed in 10 out of 11 patients.
- The mean time to hematopoietic recovery was 7.4 days.
- rh-GM-CSF was generally well-tolerated, with common adverse events including fever, nausea, and fatigue. One patient developed sagittal sinus thrombosis.
Conclusions:
- rh-GM-CSF is a viable option for accelerating hematopoietic recovery in pediatric cancer patients undergoing intensive chemotherapy.
- The treatment shows good tolerance, although careful monitoring for adverse events is warranted.
- rh-GM-CSF can be safely integrated into chemotherapy schedules for pediatric oncology patients.
Abstract:
Neutropenic pediatric patients with solid tumors and malignant lymphomas were treated with recombinant granulocyte-macrophage colony stimulating factor (rh-GM-CSF). Eleven patients, including seven lympho-reticular malignancies, two Ewing's sarcoma and one patient in each group with the diagnosis of nasopharyngeal rhabdomyosarcoma, malignant mesenchymal tumor, entered the study. Six were females and five were males, the mean age was 10.4 yr, the range was 4 to 21 years. rh-GM-CSF was given at the dose of 5 micrograms/kg s.c. daily, starting either on the day following the last day of cytotoxic chemotherapy or when ANC < 1000/ml was determined. All patients received rh-GM-CSF for a total of seven days. Hematopoietic recovery occurred in all children except one. The response to rh-GM-CSF was achieved in a mean time of 7.4 days. Tolerance to rh-GM-CSF treatment was good. Adverse events were documented as fever, nausea, vomiting, fatigue, chills and itching. Sagittal sinus thrombosis developed in one patient 5 days following the completion of chemotherapy and rh-GM-CSF cycle. In conclusion, rh-GM-CSF can be applied during the intensive chemotherapy schedules of pediatric cancer patients.