Use of colony-stimulating factors (CSF) during chemotherapy of patients with testicular cancer. A comparison between G-CSF and GM-CSF

Colony-stimulating factors (CSF) are frequently used in cases of cytostatic therapy of patients with testicular cancer assuming that they support hema topoietic recovery and, thus, shorten duration of neutropenia as well as re duce infections. Currently, G-CSF and GM-CSF are clinically used. In the pr esent study efficacy and toxicity of these two drugs were investigated and compared in patients with testicular cancer treated by standard chemotherap y. Studying 83 chemotherapy cycles applied to 31 patients with advanced ger m cell tumors the effectivity and the side effects of the two CSF were exam ined by questioning, clinical evaluation, and blood chemistry studies. C-CS F (480 mu g subcutaneously (sc)) were used in 55 and GM-CSF (400 mu g sc) i n 28 chemotherapeutic cycles. The indications consisted in the treatment of leukocytopenia on the one hand and in the prophylaxis in subsequent cycles on the other hand. No difference between the two CSF could be found either with regard to postponement of the next cycle (G-CSF: 6.8 vs. GM-CSF: 7.3 days), or to the number of injections per cycle (C-CSF: 8 vs. GM-CSF: 12.5) , or to the leukocyte (G-CSF: 2.1 vs. GM-CSF: 1.6 x 10(3)/mu l) or platelet nadir (G-CSF: 0.5 vs. GM-CSF: 0.5 x 10(5)/mu l; mean Values of all cycles, respectively). Both CSF did not seem to influence the production of platel ets. However, a difference between the two CSF was demonstrated with respec t to the toxicity. Frequency (G-CSF: 38.5 % vs. GM-CSF: 69.3 %) as well as intensity of side effects causing a change of the drug (G-CSF: n = 1 vs. GM -CSF: n = 7) were lower in the case of G-CSF. In conclusion, these data dem onstrate no difference was seen between G-CSF and GM-CSF with respect to th e efficacy in patients with testicular cancer treated by standard chemother apy. However, the use of G-CSF seems to be associated with lower toxicity.