A phase II study of continuous infusion recombinant human granulocyte-
macrophage colony-stimulating factor as an adjunct to autologous bone
marrow transplantation for patients with non-Hodgkin's lymphoma in first
remission
SJ O'Day, SN Rabinowe, D Neuberg, AS Freedman, RJ Soiffer, NA Spector, MJ Robertson, K Anderson, M Whelan and K Pesek
Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston,
MA 02115.
Recombinant human granulocyte-macrophage colony-stimulating factor
(rhGM-CSF) clearly hastens myeloid recovery in patients with relapsed
hematologic malignancies undergoing autologous bone marrow transplantation
(ABMT). In efforts to further improve neutrophil engraftment and shorten
hospital stay in ABMT patients, rhGM-CSF was administered by a potentially
more potent route (continuous infusion) to non-Hodgkin's lymphoma (NHL)
patients with better BM reserve (first remission). Time to myeloid
engraftment was compared with that of NHL patients treated in first
remission at our institution on a similar ABMT protocol but without growth
factor support (controls). Median neutrophil engraftment (absolute
neutrophil count, 500 cells/microL) in first remission patients treated
with rhGM-CSF was 14 days, compared with 22 days in controls (P = .0001).
Hospital stays were also significantly reduced for rhGM-CSF patients (P =
.0003). Platelet engraftment did not differ between the two groups.
Persistent fever and generalized serositis were the primary toxicities.
rhGM-CSF, delivered by this route, was efficacious but more toxic than
2-hour rhGM-CSF infusions previously reported by other investigators.
Future alterations in both dose and schedule may retain comparable efficacy
yet diminish toxicity.
Volume 83,
Issue 9,
pp. 2707-2714,
05/01/1994
Copyright © 1994 by The American Society of Hematology