GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation

P. Greenberg, R. Advani, A. Keating, S. C. Gulati, S. Nimer, R. Champlin, C. Karanes, N. C. Gorin, R. L. Powles, A. Smith, K. Lamborn, C. Cuffie

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Patients with non-myeloid hematologic malignancies (including Hodgkin's and non-Hodgkin's lymphomas, myeloma and acute lymphoid leukemia) or solid tumors underwent cytoreductive conditioning regimens followed by either autologous bone marrow transplantation (ABMT) (n = 343) or transplantation of peripheral blood stem cells (PBSC) with (n = 44) or without bone marrow (BM) (n = 16). In a randomized doubleblind phase III multi-center trial, patients received either granulocyte-macrophage colony-stimulating factor (GM-CSF, 10 μg/kg/day) or placebo by daily i.v., infusion beginning 24 h after bone marrow infusion and continuing until the absolute neutrophil count (ANC) had recovered to ≤ 1000/mm3, or for a maximum of 30 days. Median time to neutrophil recovery was significantly shorter in the GM-CSF group (18 vs 27 days, P < 0.001), and more GM-CSF patients had neutrophil recovery by day 30 (70 vs 48%). Median duration of hospitalization was significantly shorter in the GM-CSF group (29 vs 32 days, P = 0.02). GM-CSF significantly reduced the median time to neutrophil recovery in patients receiving bone marrow only (19 vs 27 days, P < 0.001) or PBSC with or without bone marrow (14 vs 21 days, P < 0.001). The overall incidence of adverse events was comparable in the two groups, although more patients in the GM-CSF group discontinued treatment due to adverse events (17 vs 9%, P < 0.001). No difference was noted in infection incidence or time to platelet independence. GM-CSF had no negative impact on time to relapse or long-term survival. These data indicate the positive influence of GM-CSF on neutrophil recovery acid hospital stay in patients receiving ABMT for a variety of clinical indications.

Original languageEnglish (US)
Pages (from-to)1057-1064
Number of pages8
JournalBone Marrow Transplantation
Volume18
Issue number6
StatePublished - Dec 1 1996
Externally publishedYes

Keywords

  • BMT
  • Bone marrow transplantation
  • GM-CSF

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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  • Cite this

    Greenberg, P., Advani, R., Keating, A., Gulati, S. C., Nimer, S., Champlin, R., Karanes, C., Gorin, N. C., Powles, R. L., Smith, A., Lamborn, K., & Cuffie, C. (1996). GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation. Bone Marrow Transplantation, 18(6), 1057-1064.