Skip to main content
Log in

Clinical role of GM-CSF in neutrophil recovery in relation to health care parameters

  • Review
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Recombinant human growth factors, particularly granulocyte-macrophage colony-stimulating factor (GM-CSF), have been only available for a few years. Since their introduction they have affected the management of drug-induced neutropenia, the use of dose intensive chemotherapy regimens and in the setting of autologous stem cell transplantation. This review addresses the clinical role of GM-CSF, using the data available, in neutrophil recovery in relation to various health care parameters.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wong, G.G., Witek, J.S. and Temple, P.A. (1985) Human GM-CSF: molecular cloning of the complementary DNA and puring of the natural and recombinant proteins.Science 228, 810–5.

    Article  PubMed  CAS  Google Scholar 

  2. Sieff, CA., Niemeyer, CM., Mentzer, S.J.et al. (1988) Interleukin-1, tumor necrosis factor, and the production of colony-stimulating factors by cultured mesenchymal cells.Blood 72, 1316–23.

    PubMed  CAS  Google Scholar 

  3. Vellenga, E., Rambaldi, A., Ernst, T.et al. (1988) Independent regulation of M-CSF and G-CSF gene expression in human monocytes.Blood 71, 1529–32.

    PubMed  CAS  Google Scholar 

  4. Yang, Y.C., Tsai, S., Wong, G.G.et al. (1988) Interleukin-1 regulation of haematopoietic growth factor production by human stromal hbroblasts.J. Cell. Physiol. 134, 292–6.

    Article  PubMed  CAS  Google Scholar 

  5. Bagby Jr, G.C., Dinarello, C.A., Wallance, P.et al. (1986) Interleukin-1 stimulates granulocyte macrophage colony stimulating activity release by vascular endothelial cells.J. Clin. Invest 78, 1316–1623.

    Article  PubMed  CAS  Google Scholar 

  6. Clarck, S.C. and Kamen, R. (1989) The human haematopoietic colony-stimulating factors.Science 236, 1229–37.

    Article  Google Scholar 

  7. Metcalf, D. (1985) The granulocyte-macrophage colony stimulating factors.Science 229, 16–22.

    Article  PubMed  CAS  Google Scholar 

  8. Sieff, C.A., Emerson, S.G., Donahue, R.E.et al. (1985) Human recombinant granulocyte-macrophage colony stimulating factor: a multilineage hematopoietin.Science 230, 1171–3.

    Article  PubMed  CAS  Google Scholar 

  9. Groopman, J., Mitsuyasu, R., deLeo, M.et al. (1987) Effect of recombinant human granulocyte-macrophage colony-stimulating factor on myelopoiesis in the acquired immunodeficiency syndrome.N. Engl. J. Med. 317, 593–8.

    PubMed  CAS  Google Scholar 

  10. Vadhan-Ray, S., Keating, M., Lemaistre, A.et al. (1987) Effects of recombinant human granulocyte-macrophage colony-stimulating factor in patients with myelodysplastic syndromes.N. Engl. J. Med. 317, 1545–52.

    Google Scholar 

  11. Antman, K., Grifhn, J., Elias, A.et al. (1988) Effects of recombinant human granulocyte-macrophage colony-stimulating factor on chemotherapy induced myelosuppression.N. Engl. J. Med. 319, 593–8.

    PubMed  CAS  Google Scholar 

  12. Fleischmann, J., Golde, D.W., Weisbart, R.H.et al. (1986) Granulocyte-macrophage colony stimulating factor enhances phagocytosis of bacteria by human neutrophils.Blood 68, 708–11.

    PubMed  CAS  Google Scholar 

  13. Wang, J.M., Colella, S., Alavena, P.et al. (1987) Chemotactic activity of human recombinant granulocyte-macrophage colony-stimulating factor.Immunology 60, 439–44.

    PubMed  CAS  Google Scholar 

  14. Kaplan, S.S., Basford, R.E., Wing, E. J.et al. (1989) The effect of human granulocyte-macrophage colony-stimulating factor on neutrophil activation in patients with refractory carcinoma.Blood 73, 636–38.

    PubMed  CAS  Google Scholar 

  15. Vadas, M.A., Nicola, N.A. and Metcalf, D. (1983) Activation of antibody dependent cell-mediated cytotoxicity of human neutrophils and eosinophils by separate colony stimulating factors.J. Immunol. 130, 795–9.

    PubMed  CAS  Google Scholar 

  16. Wing, E.J., Magee, D.M., Whiteside, T.L.et al. (1989) Recombinant human granulocyte-macrophage colony-stimulating factor enhances monocyte cytotoxicity and secretion of tumor necrosis factor and interferon in cancer patients.Blood 73, 643–6.

    PubMed  CAS  Google Scholar 

  17. Cannistra, S.A., Vellenga, E., Groshek, P.et al. (1988) Human granulocyte-monocyte colony stimulating factor and interleukin-3 stimulate monocyte cytotoxicity through a tumour necrosis factor-dependent mechanism.Blood 71, 672–6.

    PubMed  CAS  Google Scholar 

  18. Hazenberg, B.P.C., van Leeuwen, M.A., van Rijswijk, M.H.et al. (1989) Correction of granulocytopenia in Felty’s syndrome by granulocyte-macrophage colony-stimulating factor. Simultaneous induction of interleukin-6 release and flare-up of the arthritis.Blood 74, 2769–70.

    PubMed  CAS  Google Scholar 

  19. de Vries, E.G.E., Willemse, P.H.B., Biesma, B.et al. (1991) Flare-up of rheumatoid arthritis during GM-CSF treatment after chemotherapy.Lancet 338, 517–8.

    PubMed  Google Scholar 

  20. de Vries, E.G.E., Biesma, B., Willemse, P.H.B.et al. (1991) A double-blind placebo controlled study with macrophage colony stimulating factor during chemotherapy for ovarian carcinoma.Cancer Res. 51, 116–22.

    PubMed  Google Scholar 

  21. Cantrell, M.A., Anderson, D., Cerretti, D.P.et al. (1985) Cloning, sequence, and expression of a human granulocyte/macrophage colony-stimulating factor.Proc. Natl. Acad. Sci. USA 82, 6250–4.

    Article  PubMed  CAS  Google Scholar 

  22. Burgess, A.W., Begley, C.G., Johson, G.R.et al. (1987) Purification and properties of bacterially synthesized human granulocyte macrophage colony-stimulating factor.Blood 69, 43–51.

    PubMed  CAS  Google Scholar 

  23. Donahue, R.E., Wang, E.A., Stone, D.K.et al. (1986) Stimulation of haemopoiesis in primates by continuous infusion of recombinant human GM-CSF.Nature 321, 872–5.

    Article  PubMed  CAS  Google Scholar 

  24. Mayer, P., Lam, C, Obenaus, H.et al. (1987) Recombinant human GM-CSF induces leucocytosis and activates peripheral blood polymorphonuclear neutrophils in nonhuman primates.Blood 70, 206–13.

    PubMed  CAS  Google Scholar 

  25. Nienhuis, A.W., Donahue, R.E., Karlsson, S.et al. (1987) Recombinant human granulocyte macrophage colony-stimulating factor (GM-CSF) shortens the period of neutropenia after autologous bone marrow transplantation in a primate model.J. Clin. Invest. 80, 573–7.

    Article  PubMed  CAS  Google Scholar 

  26. Monroy, R.L., Skelly, R.R., MacVittie, T.J.et al. (1987) The effect of recombinant GM-CSF on the recovery of monkeys transplanted with autologous bone marrow.Blood 70, 1696–9.

    PubMed  CAS  Google Scholar 

  27. Gerhartz, H.H., Engelhaed, M., Meuser, P.et al. (1993) Randomized double blind placebo-controlled, phase III study of recombinant human granulocyte-macrophage colony-stimulating factor as an adjunct to induction treatment of high-grade malignant non-Hodgkin lymphomas.Blood 82, 2329–39.

    PubMed  CAS  Google Scholar 

  28. Rowe, J.M., Andersen, J.W., Mazza, J.J.et al. (1995) A randomized placebo controlled phase III study of granulocyte-macrophage colony stimulating factor in adult patients (> 55–70 years of age) with acute myelogenous leukaemia: A study of the Eastern Cooperative Oncology Group.Blood 86, 457–62.

    PubMed  CAS  Google Scholar 

  29. Löwenberg, B., Uyl-de Groot, C, Suciu, S. et al. A randomized phase III study on the value of GM-CSF administration as an adjunct to intensive remission induction chemotherapy in elderly patients with acute myeloid leukaemia. Submitted.

  30. Stone, R., Berg, D., George, S.et al. (1995) Granulocyte- macrophage colony-stimulating factor after initial chemotherapy for elderly patients with primary acute myelogenous leukaemia.N. Engl. J. Med. 332, 1671–7.

    Article  PubMed  CAS  Google Scholar 

  31. Yau, J.C., Neidhart, J.A., Triozzi, P.et al. (1996) Randomized placebo controlled trial of granulocyte-macrophage colony-stimulating-factor support for dose intensive cyclophosphamide, etoposide and cisplatin.Am. J. Hematol. 51, 289–95.

    Article  PubMed  CAS  Google Scholar 

  32. Bunn, P.A., Crowley, J., Kelly, K.et al. (1995) Chemora- diotherapy with or without granulocyte-macrophage colony-stimulating factor m the treatment of limited-stage small-cell lung cancer: a prospective phase III randomized study of the Southwest Oncology Group.J. Clin. Oncol. 13, 1632–41.

    PubMed  Google Scholar 

  33. Bodey, G.P., Anaissie, E., Gutterman, J.et al. (1994) Role of granulocyte-macrophage colony-stimulating factor as adjuvant treatment in neutropenic patients with bacterial and fungal infection.Eur. J. Clin. Microbiol. Infect. Dis. 13, 18–22.

    Article  Google Scholar 

  34. O’Shaughnessy, J., Venzon, D., Gossard, M.et al. (1995) A phase I study of sequential versus concurrent interleukin-3 and granulocyte-macrophage colony-stimulating factor in patients with advanced breast cancer treated with FLAC chemotherapy.Blood 86, 2913–21.

    PubMed  CAS  Google Scholar 

  35. O’Shaugnessy, J., Tolcher, A., Riseberg, D.et al. (1996) Prospective, randomized trial of 5-fluorouracil, leucovorin, doxorubicin and cvclophosphamide chemotherapy in combination with the interleukin-3/granulocyte-macrophage colony-stimulating factor (GM-CSF) fusion protein (PIXY321) versus GM-CSF in patients with advanced breast cancer.Blood 15, 2205–11.

    Google Scholar 

  36. Riikonen, P., Saarinen, U.M., Makipernaa,et al. (1994) Recombinant human granulocyte-macrophage colony-stimulating factor in combination with antibiotics in the treatment of febrile neutropenia: a double blind placebo controlled study in children.Pediatr. Inf. Dis. J. 13, 197- 200.

    Article  CAS  Google Scholar 

  37. Mayordomo, J.I., Rivera, F., Diaz-Puente, M.T.et al. (1995) Improving treatment of chemotherapy induced neutropenic fever by administration of colony stimulating factors.J. Natl. Cancer Inst. 87, 803–8.

    Article  PubMed  CAS  Google Scholar 

  38. Maher, D.W., Lieschke, G.J., Green, M.et al. (1994) Filgrastim in patients with chemotherapy induced febrile neutropenia. A double blind placebo controlled trial.Ann. Intern. Med. 121, 492–501.

    PubMed  CAS  Google Scholar 

  39. Vellenga, E., Uyl-de Groot, C., de Wit, R.et al. (1996) Randomized placebo controlled trial of granulocyte-macrophage colony-stimulating factor in patients with chemotherapy-related febrile neutropenia.J. Clin. Oncol. 14, 619–27.

    PubMed  CAS  Google Scholar 

  40. Uyl-de Groot, C.A., Vellenga, E. and Rutten, F. (1996) An economic model to assess the savings from a clinical application of haemopoietic growth factors (HGF).Eur. J. Cancer 32A, 57–62.

    Article  Google Scholar 

  41. Malik, I., Khan, W., Karim, M.et al. (1995) Feasibility of outpatient management of fever in cancer patients with low risk neutropenia: results of a prospective randomized trial.Am. J. Med. 98, 224–31.

    Article  PubMed  CAS  Google Scholar 

  42. Rubenstein, E., Rolston, K., Benjamin, R.et al. (1993) Outpatient treatment of febrile episodes in low-risk neutropenic patients with cancer.Cancer 71, 3640–6.

    Article  PubMed  CAS  Google Scholar 

  43. Bash, R., Katz, J., Cash, J.et al. (1994) Safety and cost- effectiveness of early hospital discharge of lower risk children with children with cancer admitted for fever and neutropenia.Cancer 74, 189–96.

    Article  PubMed  CAS  Google Scholar 

  44. Freifeld, A. and Pizzo, P. (1995) Colony stimulating factors and neutropenia: Intersection of data and clinical relevance.J. Natl. Cane. Inst 87, 781–2.

    Article  CAS  Google Scholar 

  45. Nemunaitis, J., Rabinowe, S.N., Singer, J.W.et al. (1991) Recombinant granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid cancer.N, Engl. J. Med. 324, 1773–8.

    Article  CAS  Google Scholar 

  46. Gorin, N.C., Coiffer, B., Hayat, M.et al. (1992) Recombinant human granulocyte-macrophage colony-stimulating factor after high dose chemotherapy and autologous bone marrow transplantation with unpurged and purged marrow in non-Hodgkin’s lymphoma: A double-blind placebo-controlled trial.Blood 80, 1149–57.

    PubMed  CAS  Google Scholar 

  47. Gulati, S.C. and Bennett, C.L. (1992) Granulocyte-macrophage colony-stimulating factor (GM-CSF) as an adjunct therapy in relapsed Hodgkin’s disease.Ann. Intern. Med. 116, 177–82.

    PubMed  CAS  Google Scholar 

  48. Link, H., Boogaerts, M.A., Carella, A.M.et al. (1992) A controlled trial of recombinant human granulocyte-macrophage colony-stimulating factor after total body irradiation, high dose chemotherapy, and autologous bone marrow transplantation for acute lymphoblastic leukaemia or malignant lymphoma.Blood 80, 2188–95.

    PubMed  CAS  Google Scholar 

  49. Rabinowe, S.N., Neuberg, D., Bierman, P.J.et al. (1993) Long-term follow up of a phase III study of recombinant human granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for lymphoid malignancies.Blood 81, 1903–8.

    PubMed  CAS  Google Scholar 

  50. Brandt, S.J., Peters, W.P., Atwater, S.K.et al. (1988) Effect of recombinant human granulocyte-macrophage colony- stimulating factor on haematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation.N. Engl. J. Med. 318, 869–76.

    PubMed  CAS  Google Scholar 

  51. Sheridan, W.P., Morstyn, G., Wolf, M.et al. (1989) Granulocyte colony-stimulating factor and neutrophil recovery after high-dose chemotherapy and autologous bone marrow transplantation.Lancet ii, 891–5.

    Article  Google Scholar 

  52. Taylor, K.M., Jagannath, S., Spitzer, G.et al. (1989) Recombinant human granulocyte colony-stimulating factor hastens granulocyte recovery after high-dose chemotherapy and autologous bone marrow transplantation.J. Clin. Oncol. 7, 1791–9.

    PubMed  CAS  Google Scholar 

  53. Gisselbrecht, C, Prentice, H.G., Bacigalupo, A.et al. 1990 Placebo-controlled phase III trial of lenograstim in bone- marrow transplantation.Lancet 343, 696–700.

    Article  Google Scholar 

  54. Update of recommendations for the use of hemopoietic colony-stimulating factors: Evidence based clinical practice guidelines.J. Clin. Oncol. 14, 1957–60.

  55. Gianni, A.M., Siena, S., Bregni, M.et al. 1998 Granulocytemacrophage colony-stimulating factor to harvest circulating haemopoietic stem cells for autotransplantation.Lancet ii, 580–5.

    Google Scholar 

  56. Kritz, A., Crown, J.P., Motzer, R.J.et al. (1993) Beneficial impact of peripheral blood progenitor cells in patients with metastaric breast cancer treated with high-dose chemotherapy plus granulocyte-macrophage colony-stimulating factor. A randomized trial.Cancer 71, 2515–21.

    Article  PubMed  CAS  Google Scholar 

  57. Elias, A.D., Anderson, K.C., Hunt, M.et al. (1992) Mobilization of peripheral blood progenitor cells by chemotherapy and granulocyte-macrophage colony-stimulating factor for haematologic support after high-dose intensification for breast cancer.Blood 79, 3036–44.

    PubMed  CAS  Google Scholar 

  58. Peters, W.P., Rosner, G., Ross, M.et al. (1993) Comparative effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) on priming peripheral blood progenitor cells for use with autologous bone marrow after high-dose chemotherapy.Blood 8 1, 1709–19.

    Google Scholar 

  59. Rowlings, P.A., Brayly, J.L., Rawling, CM.et al. (1994) A comparison of peripheral blood stem cell mobilization after chemotherapy with cyclophosphamide as a single agent in doses of 4 g m-2 or 7 g m-2 in patients with advanced cancer.Aust. N.Z. J. Med. 22, 660–4.

    Google Scholar 

  60. Craig, J.I.O., Anthony, R.S., Thomson, E.B. et al. (1993) Successful mobilisation of peripheral blood stem cells using 2 different doses of cyclophosphamide with G-CSF in patients with lymphoma and breast cancer. Abstract book 3rd international symposium on peripheral blood stem cell autografts Bordeaux (France), (abstr 6).

  61. Spitzer, G., Adkins, D.R., Spencer, V.etal. (1994) Randomized study of growth factors post-peripheral-blood stemcell transplant: Neutrophil recovery is improved with modest clinical benefit.J. Clin. Oncol. 12, 661–70.

    PubMed  CAS  Google Scholar 

  62. Bensinger, W., Appelbaum, F., Rowley, S.et al. (1995) Factors that influence collection and engraftment of autologous peripheral blood stem cells.J. Clin. Oncol. 13, 2547–55.

    PubMed  CAS  Google Scholar 

  63. Schmitz, N., Linch, D.C., Dreger, P.et al. (1996) Filgrastim- mobilized peripheral blood progenitor cell transplantation versus autologous bone-marrow transplantation in lymphoma patients.Lancet 3, 47353–7.

    Google Scholar 

  64. Bolwell, B.J., Fishleder, A., Andresen, S.W.et al. (1993) G- CSF primed peripheral blood progenitor cells in autologous bone marrow transplantation: parameters affecting bone marrow engraftment.Bone Marrow Transpl. 12, 609–14.

    CAS  Google Scholar 

  65. De Graaf, H., Mulder, N.H., Willemse, P.H.B.et al. (1995) Additive effect of peripheral blood stem cells, harvested with low-dose cyclophosphamide, to autologous bone marrow reinfusion on hematopoietic reconstitution after ablative chemotherapy in breast cancer patients with localized disease.Anticancer Res. 15, 2851–6.

    PubMed  Google Scholar 

  66. Brugger, W., Frisch, J.,. Schulz, G.et al. (1992) Sequential administration of interleukin-3 and granulocyte-macro- phage colony-stimulating factor following standard-dose combination chemotherapy with etoposide, ifosfamide, and cisplatin.J. Clin. Oncol. 10, 1452–9.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hofstra, L.S., Vries, E.G.E.D., Groot, C.A.UD. et al. Clinical role of GM-CSF in neutrophil recovery in relation to health care parameters. Med Oncol 13, 177–184 (1996). https://doi.org/10.1007/BF02990845

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02990845

Keywords

Navigation