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KMID : 0391319910010010110
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Korean Journal of Biological Response Modifiers
1991 Volume.1 No. 1 p.110 ~ p.117
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Clinical Use of Recombinant Human Granulocyte-Monocyte Colony Stimulating Factor(rhGM-CSF) after Allogeneic Bone Marrow Transplantation
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Han, Chi Wha
Lee, Chong Wook/Min, Woo Sung/Park, Chong Won/Kim, Choon Choo/Kim, Dong Jip
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Abstract
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Human granulocyte-macrophage colony stimulating factor(hGM-CSF) is a glycoprotein that stimulates hemopoietic precursor cells to grow and enhances the function of mature effector cells, such as neutrophils, eosinophils and macrophages. To define the clinical and hematological effects of rhGM-CSF in allogeneic bone marrow transplantation(BMT), rhGM-CSF was administered subcutaneously by once - daily injection to seven patients (severe aplastic anemia 3, acute lymphocytic leukemia 2, de novo acute myelogenous leukemia 1, secondary acute myelogenous leukemia transformed from myelofibrosis 1) at doses of 6-8 μg/Kg body weight/day from day 7+2 after infusion of bone marrow(day 0). Recovery of leukocyte and granulocyte as well as time of engraftment was significantly faster than in historical controls ; recovery time of leukocyte to>1,000/μ1 was 13 days(median) in the GM-CSF group, but 21(ABO compatible) and 28(ABO incompatible) in the historical control group. The lapse time from the beginning of injection to the day of leukocyte recovery (>1,000/μ1) was 2-15 days(median 6). The leukocyte number on the first day of GM-CSF injection related inversely to the lapse timeP within 2 days in >600 /μ1, 6-15 days(median 7) in <300/μ1. Elevation of platelet and reticulocyte counts was not observed in this study. No leukemic blasts were found during the treatment period even in patients with scute myelogenous leukemia. Five patients had minor side effects ; fever, mild general aching, back pain, facial flushing, skin rashes, dyspnea, palpitation, weakness and sudden excessive gain of body weight. In conclusion, these preliminary data showed a faster leukocyte recovery as well as early engraftment without serious side effects when 6-8 μg/Kg of rhGM-CSF was injected daily after allogeneic BMT.
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