同種骨髄移植におけるG-CSFおよびGM-CSFの臨床的有用性

A Comparison of Clinical Usefulness Between G-CSF and GM-CSF in Allogeneic Bone Marrow Transplantation

Creators Azuno Yoichi

Creators Hiroshige Yukio

Creators Nishimura Manabu

Creators OkaFuji Koichiro

Creators Tanaka Hiroyuki

Creators Seguchi Masato

Creators Yodshida tsuyoshi

Creators Inoue Yasushi

Creators Fujii Yasuhiko

Creators Matsumoto Noboru

Creators Kaku Kohei

Creators Kaneko Toshio

To evaluate the clinical usefulness of granulocyte colony-stimulating factor (G-CSF) and granulocytemacrophage colony-stimulating factor (GM-CSF) on a hematopoietic reconstitution after allogeneic bone marrow transplantation (BMT), the effects of CSFs on the recovery of hematopoietic cells in patients who received allogeneic BMT were examined. CSFs were administered intravenously from dayl or day5 to day21 after BMT. The posttransplant use of G-CSF or GM-CSF significantly reduced the duration of neutropenia ( <500/μl , p <0.05), [17.7±2.1 days in patients with G-CSF (mean±SD, n=7) and 17.3±0.5 days with GM-CSF (n=4), 23.2±3.9 days in patients who did not receive CSFs (n=5)]. The bone marrow smear showed a significant increase in immature myeloid cells in the patients with G-CSF or GM-CSF. A transient decrease in neutrophil numbers (rebound phenomenon) was frequently observed after the cessation of CSFs. Thus both G-CSF and GM-CSF showed the similar effects on the hematopoietic reconstitution after BMT. Oft the other hand* a number of adverse effects including fever, skin eruption, gastro-intestinal symptom and arrhythmia were noted in almost all patients treated with GM-CSF, while no serious adverse effects were observed in patients with G-CSF. These results suggest that G-CSF is preferable to GM-CSF in accelerating the recovery of neutrophils after allogeneic BMT.

[ISSN]0513-1731

[NCID]AN00243156