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- Title
Short-term administration of granulocyte-macrophage colony stimulating factor decreases hematopoietic toxicity of cytostatic drugs.
- Authors
Aglietta, Massimo; Monzeglio, Clara; Pasquino, Paola; Carnino, Flavio; Stern, Angelika C.; Gavosto, Felice; Aglietta, M; Monzeglio, C; Pasquino, P; Carnino, F; Stern, A C; Gavosto, F
- Abstract
<bold>Background: </bold>Administration of granulocyte-macrophage colony stimulating factor (GM-CSF) is followed by a rapid increase in the proliferative activity of the hematopoietic precursors. Within 72 hours after its suspension, however, establishment of a negative feedback results in a reduction of the proliferative activity of the hyperplastic marrow to values below the baseline, suggesting refractoriness of hematopoietic progenitors to the action of cell-cycle-specific cytostatic agents.<bold>Methods: </bold>The hypothesis that short treatment with GM-CSF before chemotherapy could reduce the hematopoietic toxicity of cytostatics was investigated by administering GM-CSF glycosylate (Sandoz, Basel, Switzerland/Schering-Plough, Kenilworth, NJ) subcutaneously with a 5.5 micrograms/kg protein dosage per day from day-6-day-4 before each course of adjuvant chemotherapy (cyclophosphamide, epirubicin, 5-fluorouracil/cyclophosphamide, methotrexate, 5-fluorouracil alternate) in patients with node-positive breast cancer. Twelve patients were randomized to receive GM-CSF before chemotherapy or only at chemotherapy. The hematologic picture and dose intensity of chemotherapy were compared in the two groups of patients.<bold>Results: </bold>In the group of patients receiving chemotherapy only, 22% of the cycles had to be postponed because of leukopenia, with a consequent reduction of the dose intensity, whereas in the GM-CSF group, the neutrophil counts remained at significantly (P < 0.001) higher levels, and there were no delays in chemotherapy administration. No substantial systemic toxicity was associated with this brief GM-CSF schedule. Moreover, GM-CSF treatment did not result in delayed depletion of the hematopoietic pool.<bold>Conclusions: </bold>Short treatment with GM-CSF can enable the dose intensity of conventional protocols of proven efficacy to be increased.
- Publication
Cancer (0008543X), 1993, Vol 72, Issue 10, p2970
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/1097-0142(19931115)72:10<2970::AID-CNCR2820721018>3.0.CO;2-0