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Granulocyte-macrophage colony-stimulating factor in combination with pentavalent antimony for the treatment of visceral leishmaniasis

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Abstract

The efficacy of GM-CSF was investigated in 20 neutropenic patients (< 1500 neutrophils/µl) with acute visceral leishmaniasis due toLeishmania chagasi. Patients were randomized to receive either GM-CSF, 5 µg/kg daily (intravenously or subcutaneously), or placebo for ten days, in combination with pentavalent antimony, 10–20 mg/kg daily for 20 days. Neutrophil counts were significantly greater on days 5 and 10 of treatment in the GM-CSF group compared with the placebo group (p<0.02). Eosinophil and monocyte counts were also significantly increased in the GM-CSF group at day 10 (p≤0.03). Interestingly, at day 30, platelet counts were significantly higher in the GM-CSF treated group (p=0.007). Haemoglobin levels were significantly increased in the GM-CSF group on days 5 and 10 (p=0.04 and 0.02, respectively). Patients in the GM-CSF group experienced fewer secondary bacterial or viral infections than placebo patients. Infections occurred in only three patients given GM-CSF compared with eight patients given placebo (p<0.04). All patients had complete resolution of disease symptoms at three months. Few adverse events were recorded. GM-CSF given subcutaneously at a dose of 5 µg/kg daily for ten days was well tolerated, reversed neutropenia rapidly and reduced the number of secondary infections in patients with leishmaniasis.

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Authors and Affiliations

  1. Federal University of Bahia, Salvador, Bahia, Brazil

    R. Badaró, C. Nascimento, J. S. Carvalho & F. Badaró

  2. Division of International Medicine, Cornell University Medical College, New York, USA

    R. Badaró, J. L. Ho, S. G. Reed & W. D. Johnson Jr.

  3. Seattle Biomedical Research Institute, Seattle, Washington, USA

    D. Russo

  4. Sandoz Pharma Ltd, Clinical Research, Basel, Switzerland

    T. C. Jones

Authors
  1. R. Badaró
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  2. C. Nascimento
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  3. J. S. Carvalho
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  4. F. Badaró
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  5. D. Russo
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  6. J. L. Ho
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  7. S. G. Reed
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  8. W. D. Johnson Jr.
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  9. T. C. Jones
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Badaró, R., Nascimento, C., Carvalho, J.S. et al. Granulocyte-macrophage colony-stimulating factor in combination with pentavalent antimony for the treatment of visceral leishmaniasis. Eur. J. Clin. Microbiol. Infect. Dis. 13 (Suppl 2), S23–S28 (1994). https://doi.org/10.1007/BF01973598

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