Granulocyte-macrophage-colony stimulating factor for prevention of neutropenia and infections in children and adolescents with solid tumors. Results of a prospective randomized study

✍ Scribed by Stefan E. G. Burdach; Markus Müschenich; Wolfgang Josephs; Jürgen Frisch; Gregor Schulz; Heribert Jürgens; Ulrich Göbel

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 605 KB
• Volume: 76
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19950801)76:3<510::aid-cncr2820760323>3.0.co;2-w

✦ Synopsis

Background. Chemotherapy is an essential modality of curative strategies in pediatric oncology. Dose and dose intensity are, above all, restricted by the myelosuppressive effects of cytotoxic drugs. Neutropenia constitutes an important risk of morbidity and mortality. Granulocytemacrophage-colony stimulating factor (GM-CSF ] is a hematopoietic growth factor that increases the number of circulating neutrophils as demonstrated in adults.

Methods. A prospective randomized study of the effects of GM-CSF was performed with 11 patients who were treated for solid tumors and received GM-CSF for 2 weeks starting 48 hours after completion of chemotherapy. Forty-two intraindividual identical chemotherapycourses with and 42 without GM-CSF were compared. The monitoring program included the surveillance of the hematological reconstitution and the number and duration of infectious episodes.

Results. The average nadir of the absolute neutrophil count (ANC) with GM-CSF was higher than without GM-CSF. The average number of days with an ANC below 500/pl was significantly reduced by GM-CSF. Fewer infectious episodes were observed among those who re-From the