Infection

, Volume 20, Issue 2, pp S95–S99 | Cite as

Granulocyte-macrophage colony-stimulating factor (GM-CSF): what role in bone marrow transplantation?

  • M. W. Schuster
Article

Summary

Infection during the period of bone marrow aplasia remains one of the major risks associated with high-dose chemotherapy and transplantation. Over the past several years, a number of investigators in Europe and North America have evaluated the use of GM-CSF in the setting of autologous bone marrow transplantation. These studies have almost all shown a hastening of myeloid engraftment. This, for the most part, has led to fewer serious infections and a decreased hospital stay for the GM-CSF treated patients. An overall survival advantage has not been noted. There has also not been any consistent multi-lineage effect. Future trials with combinations of sequentially used cytokines may lead to more rapid recovery of red blood cells and platelets in addition to granulocytes.

Welche Bedeutung hat der Granulozyten-Makrophagen-stimulierende Faktor (GM-CSF) bei der Knochenmarktransplantation?

Zusammenfassung

Infektionen in der Phase der Knochenmarkaplasie nach Hochdosis-Chemotherapie und Knochenmarktransplantation stellen nach wie vor eine große Gefahr dar. Der Einsatz von GM-CSF bei autologer Knochenmarktransplantation wurde in den vergangenen Jahren von mehreren Forschungsgruppen in Europa und Nordamerika erprobt. In fast allen Studien wurde eine Beschleunigung des Knochenmark-Engraftment beobachtet. Bei den meisten mit GM-CSF behandelten Patienten war dies mit einer Reduktion schwerer Infektionen und Verkürzung des Krankenhausaufenthaltes verbunden. Doch war insgesamt keine Lebensverlängerung nachzuweisen. Eine Beeinflussung multipler Zellinien konnte nicht konstant festgestellt werden. Eine raschere Erholung der Erythrozyten und Thrombozyten und nicht nur der Granulozyten wird mit der sequentiellen Anwendung kombinierter Zytokine erwartet, die in zukünftigen Studien geprüft werden sollen.

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Copyright information

© MMV Medizin Verlag GmbH München 1992

Authors and Affiliations

  • M. W. Schuster
    • 1
  1. 1.Don Monti Div. of Oncology and Div. of Hematology, Dept. of MedicineNorth Shore University Hospital — Cornell University Medical CollegeManhassetUSA

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