Effect of GM-CSF on Neutropenia Induced by Chemotherapy or Immunotherapy in Patients with Urologic Malignancy

Jeon, Sung Hyun; Chang, Sung Goo

Abstract

Purpose
Neutropenia is a major factor contributing to morbidity and mortality in patients undergoing chemotherapy for cancer. The efficacy and complications of GM- CSF (Granulocyte-Macrophage colony stimulating factor) on the neutropenia induced by chemotherapy or immunotherapy were evaluated in patients with a urologic malignancy. Material and Methods: Twenty-nine patients with a histologically confirmed urologic malignancy, who presented with neutropenia during either chemotherapy or immunotherapy, were given a fixed dose (400microgram) of GM-CSF subcutaneously for three to fifteen days. Twenty-nine patients with neutropenia were given GM-CSF for 50 cycles. The patients were evaluated by means of a complete blood cell count, white cell and differential counts. The mean time to response was 2.3 days. The statistical significance of the differences was calculated using a paired t test.
RESULTS
GM-CSF treatment in patients with neutropenia resulted in an increase in the mean neutrophil count, the eosinophil count, and the monocyte count. Complications of GM-CSF included fever (76%), GI problems (19%), headache (14%), bone pain (14%), arthralgia (10%), and urticaria (5%).
CONCLUSIONS
GM-CSF may be useful in reducing the toxicity of chemotherapy. Therefore, GM-CSF can be used to increase the effect of chemotherapy without delaying or stopping treatment as a result of neutropenia.