High-dose chemoradiotherapy combined with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) followed by autologous peripheral blood stem cell transplantation (PBSCT) in a case of refractory acute myelogenous leukemia (AML)

Ryuji Tanosaki, Shinichiro Okamoto, S. Takahashi, T. Inoue, K. Kikuno, Y. Aoki, M. Takada, S. Irie, M. Shimane, A. Tojo

Research output: Contribution to journalArticle

Abstract

Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) stimulates the growth of myeloid leukemic cells and increases their susceptibility to cell-cycle specific agents. We treated a patient with acute myelogenous leukemia (AML) in a state of second resistant relapse, with high-dose chemoradiotherapy combined with rhGM-CSF (total body irradiation: TBI 3Gy x 4, on days -8 & -7; cytosine arabinoside: Ara-C 3g/m2, iv, q12h, on days -5-2; rhGM-CSF 250 micrograms/m2/day, cont.iv, on days -5-2) followed by autologous peripheral blood stem cell transplantation (PBSCT). In this case, rhGM-CSF enhanced the proliferation of leukemic cells in vitro. The test dose of rhGM-CSF (84 micrograms/m2 over 8 hours) also promoted leukemic cell proliferation in vivo, resulting in an increase in the percentage of leukemic cells in the peripheral blood and reappearance of chromosomal aberrations in the bone marrow. The toxicity of rhGM-CSF-combined conditioning regimen included fever and mild liver damage. The patient achieved a complete remission lasting for 2 months, then relapsed. The rhGM-CSF-combined conditioning regimen was tolerated by this patient, but further studies will be required to confirm not only its safety but also its effectiveness in the treatment of refractory AML.

Original languageEnglish
Pages (from-to)946-951
Number of pages6
Journal[Rinsho ketsueki] The Japanese journal of clinical hematology
Volume34
Issue number8
Publication statusPublished - 1993 Aug

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Peripheral Blood Stem Cell Transplantation
Chemoradiotherapy
Granulocyte-Macrophage Colony-Stimulating Factor
Acute Myeloid Leukemia
Cytarabine
Cell Proliferation
Whole-Body Irradiation
Myeloid Cells
Chromosome Aberrations
Cell Cycle
Fever
Bone Marrow
Safety
Recurrence
Liver
Growth

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "High-dose chemoradiotherapy combined with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) followed by autologous peripheral blood stem cell transplantation (PBSCT) in a case of refractory acute myelogenous leukemia (AML)",
abstract = "Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) stimulates the growth of myeloid leukemic cells and increases their susceptibility to cell-cycle specific agents. We treated a patient with acute myelogenous leukemia (AML) in a state of second resistant relapse, with high-dose chemoradiotherapy combined with rhGM-CSF (total body irradiation: TBI 3Gy x 4, on days -8 & -7; cytosine arabinoside: Ara-C 3g/m2, iv, q12h, on days -5-2; rhGM-CSF 250 micrograms/m2/day, cont.iv, on days -5-2) followed by autologous peripheral blood stem cell transplantation (PBSCT). In this case, rhGM-CSF enhanced the proliferation of leukemic cells in vitro. The test dose of rhGM-CSF (84 micrograms/m2 over 8 hours) also promoted leukemic cell proliferation in vivo, resulting in an increase in the percentage of leukemic cells in the peripheral blood and reappearance of chromosomal aberrations in the bone marrow. The toxicity of rhGM-CSF-combined conditioning regimen included fever and mild liver damage. The patient achieved a complete remission lasting for 2 months, then relapsed. The rhGM-CSF-combined conditioning regimen was tolerated by this patient, but further studies will be required to confirm not only its safety but also its effectiveness in the treatment of refractory AML.",
author = "Ryuji Tanosaki and Shinichiro Okamoto and S. Takahashi and T. Inoue and K. Kikuno and Y. Aoki and M. Takada and S. Irie and M. Shimane and A. Tojo",
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T1 - High-dose chemoradiotherapy combined with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) followed by autologous peripheral blood stem cell transplantation (PBSCT) in a case of refractory acute myelogenous leukemia (AML)

AU - Tanosaki, Ryuji

AU - Okamoto, Shinichiro

AU - Takahashi, S.

AU - Inoue, T.

AU - Kikuno, K.

AU - Aoki, Y.

AU - Takada, M.

AU - Irie, S.

AU - Shimane, M.

AU - Tojo, A.

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AB - Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) stimulates the growth of myeloid leukemic cells and increases their susceptibility to cell-cycle specific agents. We treated a patient with acute myelogenous leukemia (AML) in a state of second resistant relapse, with high-dose chemoradiotherapy combined with rhGM-CSF (total body irradiation: TBI 3Gy x 4, on days -8 & -7; cytosine arabinoside: Ara-C 3g/m2, iv, q12h, on days -5-2; rhGM-CSF 250 micrograms/m2/day, cont.iv, on days -5-2) followed by autologous peripheral blood stem cell transplantation (PBSCT). In this case, rhGM-CSF enhanced the proliferation of leukemic cells in vitro. The test dose of rhGM-CSF (84 micrograms/m2 over 8 hours) also promoted leukemic cell proliferation in vivo, resulting in an increase in the percentage of leukemic cells in the peripheral blood and reappearance of chromosomal aberrations in the bone marrow. The toxicity of rhGM-CSF-combined conditioning regimen included fever and mild liver damage. The patient achieved a complete remission lasting for 2 months, then relapsed. The rhGM-CSF-combined conditioning regimen was tolerated by this patient, but further studies will be required to confirm not only its safety but also its effectiveness in the treatment of refractory AML.

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