RHGM-CSF AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION FROM UNRELATED DONORS - A PILOT-STUDY OF CYCLOSPORINE AND PREDNISONE AS GRAFT-VERSUS-HOST DISEASE PROPHYLAXIS

Cyclosporine and prednisone were administered as graft-versus-host dis ease (GVHD) prophylaxis to nine patients undergoing marrow transplant from HLA matched, unrelated donors. RhGM-CSF was administered at a dos e of 250 mug/m2 daily to all patients. The median day of neutrophil re covery to greater-than-or-equal-to 500/mm3 was Day 16. Four patients d eveloped Grade II acute GVHD and four developed Grade III acute GVHD. One patient, who survived only 25 days, did not develop GVHD at all. O ne patient developed systemic infection within the first 28 days after marrow infusion. Comparison of these data to a prior series of patien ts undergoing bone marrow transplant (BMT) from unrelated donors who w ere treated with rhGM-CSF along with methotrexate and cyclosporine for GVHD prophylaxis suggests that rhGM-CSF is well-tolerated, neutrophil recovery may be earlier but the severity of GVHD does not appear redu ced. Selection of the GVHD prophylaxis regimen may affect the hematopo ietic response to cytokine therapy. Further trials with rhGM-CSF in pa tients undergoing BMT from unrelated donors are required.