UNEXPECTED HEPATOTOXICITY AFTER PRIMING AND TREATMENT WITH MOLGRAMOSTIM (RHGM-CSF) IN ACUTE MYELOID-LEUKEMIA DURING INDUCTION CHEMOTHERAPY

The effect of supplementing induction chemotherapy with recombinant hu man granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was st udied in a randomized trial of 18 patients with acute myeloid leukemia (AML). Ten patients received rhGM-CSF, starting on day one to three b efore chemotherapy and continued for a maximum of 21 days after the st art of induction treatment. Unexpected adverse effects of rhGM-CSF and chemotherapy combination included a transient decline in plasma coagu lation factors II, VII, and X (5 of 5 patients) and an increased trans capillary escape rate of albumin (in 3 of 3 patients tested). The decl ine in coagulation factors was prevented in subsequent patients by pro phylactic treatment with vitamin K. Although the small number of patie nts studied may not allow a definite conclusion, caution with regard t o liver function should be shown in combining rhGM-CSF with intensive chemotherapy. (C) 1995 Wiley-Liss, Inc.