Klingemann H G, Wilkie-Boyd K, Rubin A, Onetto N, Nantel S H, Barnett M J, Reece D E, Shepherd J D, Phillips G L
Leukemia/Bone Marrow Transplantation Program of British Columbia, Vancouver General Hospital, Canada.
Biotechnol Ther. 1994;5(1-2):1-13.
Recombinant yeast-derived granulocyte-macrophage colony-stimulating factor (GM-CSF) was administered to 10 patients after autologous bone marrow transplantation for Hodgkin's disease given as a 24-h continuous intravenous infusion from the day of marrow infusion until the patient had obtained an absolute neutrophil count of 1.5 x 10(9)/L for 2 consecutive days or until day 30, whichever occurred first. Results were compared with results from 18 historical control patients who did not receive GM-CSF but were otherwise treated in a similar fashion. The infusion of GM-CSF led to a significantly faster neutrophil and monocyte recovery compared to the patients in the historical control group. The median days to achieve an absolute neutrophil count for the GM-CSF group and the control group were 0.5 x 10(9)/L; 9.5 and 14 days; 1.0 x 10(9)/L: 10 and 18 days; 1.5 x 10(9)/L: 11 and 29 days. No significant difference was found with respect to platelet engraftment and red cell transfusion requirements. GM-CSF therapy was discontinued at a median of 12 days. Hospitalization was also shorter for the GM-CSF group (22.5 vs. 26.5 days) and no patient in the GM-CSF group had to be readmitted after initial discharge. The incidence of documented infections was similar among both patient groups and no difference was noted in terms of antimicrobial usage. Some side effects occurred with the continuous infusion of GM-CSF, particularly fluid retention, dyspnea, fever, diarrhea, and bone pain leading to early discontinuation of GM-CSF in 2 patients. The data suggest that a continuous 24-h infusion of GM-CSF significantly accelerates myeloid engraftment, leading to earlier discharge from the hospital.
重组酵母衍生的粒细胞-巨噬细胞集落刺激因子（GM-CSF）在10例霍奇金病患者自体骨髓移植后给药，从骨髓输注日开始进行24小时持续静脉输注，直至患者连续2天获得绝对中性粒细胞计数为1.5×10⁹/L或直至第30天，以先发生者为准。将结果与18例未接受GM-CSF但其他治疗方式相似的历史对照患者的结果进行比较。与历史对照组患者相比，GM-CSF输注导致中性粒细胞和单核细胞恢复明显更快。GM-CSF组和对照组达到绝对中性粒细胞计数的中位天数分别为：0.5×10⁹/L：9.5天和14天；1.0×10⁹/L：10天和18天；1.5×10⁹/L：11天和29天。在血小板植入和红细胞输血需求方面未发现显著差异。GM-CSF治疗的中位时间为12天。GM-CSF组的住院时间也较短（22.5天对26.5天），且GM-CSF组没有患者在首次出院后需要再次入院。两组患者中记录在案的感染发生率相似，在抗菌药物使用方面也没有差异。持续输注GM-CSF会出现一些副作用，特别是液体潴留、呼吸困难、发热、腹泻和骨痛，导致2例患者提前停用GM-CSF。数据表明，24小时持续输注GM-CSF可显著加速髓系植入，从而使患者更早出院。
