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Human recombinant granulocyte‐macrophage colony stimulating factor (hrGM‐CSF) improves double hemibody irradiation (DHBI) tolerance in patients with stage III multiple myeloma: A pilot study
Author(s) -
Troussard X.,
Macro M.,
Vie B.,
Batho A.,
Peny A. M.,
Reman O.,
Tabah I.,
Leporrier M.
Publication year - 1995
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.1365-2141.1995.tb08929.x
Subject(s) - medicine , granulocyte macrophage colony stimulating factor , granulocyte colony stimulating factor , multiple myeloma , chemotherapy , gastroenterology , macrophage colony stimulating factor , immunology , cytokine , macrophage , biology , biochemistry , in vitro
Summary. Double hemibody irradiation (DHBI) is an alternative treatment of stage III multiple myeloma (MM) in patients aged over 55 years. Toxic side‐effects such as myelosuppression are a severe limiting factor to its use. We performed DHBI associated with human recombinant granulocyte‐macrophage colony stimulating factor (hrGM‐CSF) as support therapy in 10 patients with stage III MM to improve the tolerance to this treatment. Ten patients received subcutaneously 5 μg/kg/d of hrGM‐CSF during 2 weeks after each course of hemibody irradiation. All these patients had stage III MM: eight previously received chemotherapy, six of them were regarded as patients with refractory MM and two with relapse. Two patients received DHBI as first‐line treatment. hrGM‐CSF increased safety and tolerance of DHBI. GM‐CSF support reduced the mean time between upper body irradiation (UBI) and lower body irradiation (LBI): 41v108d in a cohort of 32 patients previously treated without growth factor support. Overall there was no lethal infection with hrGM‐CSF or granulocytopenia (5.0 × 10 9 /1 v 0.4 × 10 9 /l at day 15 in patients without growth factor). hrGM‐CSF also reduced stomatitis grading and thrombocytopenia (90 × 10 9 /l v 45 × 10 9 /l at day 15). Furthermore, hrGM‐CSF increased blood colony forming unit‐granulocyte macrophage (CFU‐GM) and was well tolerated in all but one patient. hrGM‐CSF reduces toxic side‐effects of DHBI, thus providing an effective treatment in patients with advanced and resistant MM.