RETROSPECTIVE ANALYSIS OF INFECTIOUS-DISEASE IN PATIENTS WHO RECEIVEDRECOMBINANT HUMAN GRANULOCYTE-MACROPHAGE COLONY-STIMULATING FACTOR VERSUS PATIENTS NOT RECEIVING A CYTOKINE WHO UNDERWENT AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR TREATMENT OF LYMPHOID CANCER

Recombinant human granulocyte-macrophage colony-stimulating factor (rh GM-CSF) significantly shortens the number of days required to achieve an absolute neutrophil count of >500/mm(3) after autologous bone marro w transplantation (ABMT); however, the ability of rhGM-CSF to enhance neutrophil and macrophage function in vivo has been incompletely chara cterized. In this retrospective study, the authors compared the incide nce of infection from the day of transplantation to 28 days posttransp lantation between two groups of previously studied patients who underw ent ABMT at the Fred Hutchinson Cancer Research Center. A control grou p that received no cytokine was compared with a study group that recei ved rhGM-CSF while participating in phase I, II, or III trials. During the posttransplantation period when both study groups had severe neut ropenia, 40% (38 of 95) of control patients were found to have an infe ction, whereas only 13% (6 of 46) of rhGM-CSF patients developed an in fection (p = 0.001). Most infections occurred before an absolute neutr ophil count of >100/mm(3) was achieved. There was a trend toward fewer fungal infections (14% vs. 4%; p = 0.093); gram-negative bacterial in fections (6% vs. 0%; p = 0.083); pulmonary infections (12% vs. 2%; p = 0.062); fewer days of amphotericin B (p = 0.0305); and fewer days of intravenous antibiotics (p = 0.0791) in rhGM-CSF-treated patients. The se results support in vivo findings that the function-enhancing effect of rhGM-CSF may reduce infection-related complications.