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

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

Research output: Contribution to journalArticle

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

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Hematopoietic Stem Cell Transplantation
Granulocyte-Macrophage Colony-Stimulating Factor
Neutrophils
Bone Marrow
Autologous Transplantation
Bone Marrow Transplantation
Peripheral Blood Stem Cell Transplantation
Incidence
Hematologic Neoplasms
Hodgkin Disease
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Non-Hodgkin's Lymphoma
Length of Stay
Hospitalization
Blood Platelets
Placebos
Recurrence
Acids
Survival
Infection

Keywords

  • BMT
  • Bone marrow transplantation
  • GM-CSF

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Greenberg, P., Advani, R., Keating, A., Gulati, S. C., Nimer, S. D., Champlin, R., ... Cuffie, C. (1996). GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation. Bone Marrow Transplantation, 18(6), 1057-1064.

GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation. / Greenberg, P.; Advani, R.; Keating, A.; Gulati, S. C.; Nimer, Stephen D; Champlin, R.; Karanes, C.; Gorin, N. C.; Powles, R. L.; Smith, A.; Lamborn, K.; Cuffie, C.

In: Bone Marrow Transplantation, Vol. 18, No. 6, 01.12.1996, p. 1057-1064.

Research output: Contribution to journalArticle

Greenberg, P, Advani, R, Keating, A, Gulati, SC, Nimer, SD, Champlin, R, Karanes, C, Gorin, NC, Powles, RL, Smith, A, Lamborn, K & Cuffie, C 1996, 'GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation', Bone Marrow Transplantation, vol. 18, no. 6, pp. 1057-1064.
Greenberg P, Advani R, Keating A, Gulati SC, Nimer SD, Champlin R et al. GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation. Bone Marrow Transplantation. 1996 Dec 1;18(6):1057-1064.
Greenberg, P. ; Advani, R. ; Keating, A. ; Gulati, S. C. ; Nimer, Stephen D ; Champlin, R. ; Karanes, C. ; Gorin, N. C. ; Powles, R. L. ; Smith, A. ; Lamborn, K. ; Cuffie, C. / GM-CSF accelerates neutrophil recovery after autologous hematopoietic stem cell transplantation. In: Bone Marrow Transplantation. 1996 ; Vol. 18, No. 6. pp. 1057-1064.
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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.",
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