USE OF GM-CSF AS PROPHYLAXIS OF GANCICLOV IR-INDUCED - SEVERE BONE-MARROW SUPPRESSION

We report the first experience of the use of GM-CSF as prophylaxis of ganciclovir induced severe bone marrow suppression in a CMV seropositi ve patient with acute myeloid leukemia who underwent a complete remiss ion after an allogeneic bone marrow transplantation from an identical HLA sibling who also was CMV seropositive. A succesful bone marrow eng raftment was documented by day 14. Once peripheral blood counts stabil ized, the patient received ganciclovir 5 mg/kg TIW. By day 73 severe n eutropenia was documented but a spontaneous improvement ocurred with d iscontinuation of ganciclovir. From day 100 to day 110 he received dai ly ganciclovir at a dose of 5 mg/kg and the same dose of GM CSF withou t signs of toxicity. There was no evidence of either acute graft versu s host disease or of CMV infection. One year after transplantation he relapsed and died of complications of acute leukemia.