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PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
1990-5-24
pubmed:abstractText
Chemotherapy (CT) induced critical cytopenia remains as the major dose limiting problem in the treatment of acute leukemias. This is especially true in patients at high risk of early death due to high intensity chemotherapy for relapse or to higher age. In an attempt to reduce the phase of risk we administered human recombinant GM-CSF to 23 patients at a median age of 65 (range 17-84) years including 8 acute myelogenous (AML) and 5 lymphoblastic (ALL) leukemias after early or second relapses and 10 patients of 65 years and older in primary induction treatment for AML. 3 patients with AML had prior bone marrow transplantation. 4 AML's were secondary to tumor chemotherapy (2) or myelodysplastic syndrome (2). The study was part of chemotherapeutic phase II and III studies using TAD9 for primary induction chemotherapy and S-HAM for relapses. Starting on day 4 after the end of intensive CT GM-CSF 250 micrograms/m2/day was given by continuous i.v. infusion and after recovery of neutrophils was deescalated in two 4 day steps and discontinued. 12/23 patients achieved a complete remission (CR) and median age of responders is 61 (range 17-84) years. In the group of the non-transplanted patients the median recovery time of neutrophils is reduced by one week when compared to controls receiving the same chemotherapy (p = 0.002). We observed a leukemic regrowth in 3 patients of 61, 70, and 78 years, 2 of whom having secondary AML. After discontinuation of GM-CSF the regrowth of blasts was reversible in 1 patient and continued unaffectedly in its kinetics in 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0171-7111
pubmed:author
pubmed:issnType
Print
pubmed:volume
33
pubmed:owner
NLM
pubmed:authorsComplete
N
pubmed:pagination
724-31
pubmed:dateRevised
2006-4-24
pubmed:meshHeading
pubmed-meshheading:2182462-Acute Disease, pubmed-meshheading:2182462-Adolescent, pubmed-meshheading:2182462-Adult, pubmed-meshheading:2182462-Age Factors, pubmed-meshheading:2182462-Aged, pubmed-meshheading:2182462-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:2182462-Bone Marrow Transplantation, pubmed-meshheading:2182462-Colony-Stimulating Factors, pubmed-meshheading:2182462-Combined Modality Therapy, pubmed-meshheading:2182462-Drug Resistance, pubmed-meshheading:2182462-Granulocyte-Macrophage Colony-Stimulating Factor, pubmed-meshheading:2182462-Growth Substances, pubmed-meshheading:2182462-Humans, pubmed-meshheading:2182462-Leukemia, pubmed-meshheading:2182462-Leukocyte Count, pubmed-meshheading:2182462-Life Tables, pubmed-meshheading:2182462-Middle Aged, pubmed-meshheading:2182462-Neoplasm Recurrence, Local
pubmed:year
1990
pubmed:articleTitle
Recombinant human granulocyte-macrophage colony-stimulating factor after chemotherapy for acute leukemias at higher age or after relapse.
pubmed:affiliation
Department of Hematology/Oncology, University of Münster, FRG.
pubmed:publicationType
Journal Article