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The effect of macrophage colony‐stimulating factor on haemopoietic recovery after autologous bone marrow transplantation
Author(s) -
Khwaja Asim,
Yong Kwee,
Jones H. Mark,
Chopra Rajesh,
McMillan Andrew K.,
Goldstone Anthony H.,
Patterson Keith G.,
Matheson Catherine,
Ruthven Karen,
Abramson Stephan B.,
Linch David C.
Publication year - 1992
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1992.tb08222.x
Subject(s) - medicine , bone marrow , transplantation , platelet , monocyte , macrophage colony stimulating factor , granulocyte colony stimulating factor , leukopenia , absolute neutrophil count , hematopoietic growth factor , colony stimulating factor , granulocyte macrophage colony stimulating factor , immunology , gastroenterology , cytokine , macrophage , haematopoiesis , chemotherapy , neutropenia , stem cell , biology , biochemistry , genetics , in vitro
Summary. Macrophage colony‐stimulating factor (M‐CSF) is active in the late stages of monocyte maturation, activates mature monocyte‐macrophages and enhances their production of various other cytokines. We have examined the effects of a 21 d course of escalating doses of M‐CSF purified from human urine (hM‐CSF) on recovery following autologous bone marrow transplantation (ABMT) in 20 patients with malignant lymphomas. Four patients were treated at each dose level of 4, 8, 16, 32 and 64.109 9 U/m 2 /d and results compared to 46 concurrent controls. There was no significant difference in recovery to an absolute neutrophil count (ANC) of 0.5×10 9 /1 (median 20 d in hM‐CSF group versus 22 in controls) or in recovery of platelets to 50.10 9 /1 (32 d versus 39 d, 0.05< P <0.1); hM‐CSF patients received a median of 81 platelet units following ABMT (controls 112 units, P = NS). hM‐CSF patients had a median of 5.5 d with fever >37.5°C (control 8, P =NS), received parenteral antibiotics for 14.5 d (control 17, P=NS) and had a 50% incidence of bacteraemia (control 48%). hM‐CSF treated patients were discharged by a median of day 29 following transplantation (control 33, P <0.05). Platelet and neutrophil recovery correlated significantly with the number of marrow mononuclear cells (MNC) reinfused in the hM‐CSF group (P=0.05 and P=0.014 respectively) but not in controls. Subgroup analysis showed that hM‐CSF patients receiving > 2.10 8 MNC/kg body weight reached an ANC of 0.5×10 9 /1 by a median of day 16.5 (control 18.5, NS), became platelet transfusion independent by day 17 (control 29, P <0.05) and reached a platelet count of 50.10 9 /1 by day 21 (control 40, P <0.05). No significant toxicity attributable to hM‐CSF treatment was seen. These results suggest that hM‐CSF accelerates platelet recovery following ABMT and that relatively large marrow innocula are required to see this effect.