MODULATION OF ALLOGENEIC IMMUNE-RESPONSES BY FILGRASTIM (RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR) IN BONE-MARROW TRANSPLANTATION

We examined whether the use of G-CSF would affect the outcome of allog eneic marrow transplantation in humans and mice, Retrospective analysi s of 24 patients who had received allogeneic marrow grafts from HLA-id entical siblings revealed that the incidence of chronic but not acute graft-versus-host disease (GVHD) was lower in the patients receiving G -CSF than in those not given G-CSF (18% vs. 80%, P = 0.02). There was a difference in serum TNF-alpha levels during the first 3 months after transplant between these two groups. Four out of the ten patients who were not given G-CSF showed elevated serum TNF-alpha> levels, whereas there was only one patient with an increased TNF-cu level among eleve n patients who were given G-CSF. With the use of murine acute and chro nic GVHD models, we also observed that administration of G-CSF improve d the survival of minor GVHD, but not major GVHD, mice. Taken together , these findings suggest that G-CSF down-regulates allogeneic immune r esponses and is active in modulating alloreactivity in vivo.