GM-CSF in Addition to Chemotherapy of ALL for Kinetics Based Protection of Stem Cells and Stimulation of Haemopoiesis.A randomized Study

  • Jerzy Holowiecki
Conference paper
Part of the NATO ASI Series book series (volume 94)


Intensive induction chemotherapy regimens has led to considerable improvement in the prognosis of adult acute lymphoblastic leukemia (ALL), but the results are still unsatisfactory and only about 35% of patients can be cured with current available therapy (7,10,11,14,). In conclusions from the studies of large series of adult ALL the complete remission (CR) rate ranges from 70 to 85% ( 2,6,7, 9,10, 11, 14,16,23,27,30 ). A further intensification of chemotherapy will increase CR rates but it is limited by hematopoietic toxicity and therefore the use of recombinant human growth factors in addition to induction chemotherapy has been attempted ( 13,18,19,22,23,25,29 ). The studies on bone marrow cells kinetics during GM-CSF treatment revealed, that 48 to 96 hours after GM-CSF discontinuation the proliferative activity of normal stem cells and progenitors decreases to levels lower than that observed prior to GM-CSF administration ( 1,5,12,28 ), so this represents a period of partial refractoriness of these cells to the cell cycle dependent cytostatics.


Acute Lymphoblastic Leukemia Normal Stem Cell Peripheral Blood CD34 Adult Acute Lymphoblastic Leukemia Relative Refractoriness 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • Jerzy Holowiecki
    • 1
  1. 1.Department of HaematologySilesian Medical AcademyKatowicePoland

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