Enhanced marrow recovery by short preincubation of marrow allografts with human recombinant interleukin-3 and granulocyte-macrophage colony-stimulating factor

• Published in: Blood Vol. 80; no. 7; pp. 1673 - 1678
• Main Authors: NAPARSTEK, E, HARDAN, Y, BEN-SHAHAR, M, NAGLER, A, OR, R, MUMCUOGLU, M, WEISS, L, SAMUEL, S, SLAVIN, S
• Format: Journal Article
• Language: English
• Published: Washington, DC The Americain Society of Hematology 01.10.1992
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone Marrow - drug effects; Bone Marrow Transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Female; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; Humans; Interleukin-3 - therapeutic use; Leukemia - surgery; Leukemia, Myeloid - surgery; Leukemia, Myeloid, Acute - surgery; Male; Medical sciences; Myelodysplastic Syndromes - surgery; Precursor Cell Lymphoblastic Leukemia-Lymphoma - surgery; Recombinant Proteins - therapeutic use; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Treatment Outcome; Human; Treatment; Hematopoiesis; Interleukin 3; Immunotherapy; Cytokine; Homograft; Bone marrow; Malignant hemopathy; Resuscitation; Granulocyte macrophage colony stimulating factor
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V80.7.1673.1673

We studied an alternative method of using hematopoietic growth factors (HGFs) to enhance hematopoietic recovery in patients undergoing bone marrow transplantation (BMT), by short in vitro preincubation. Twenty consecutive patients with leukemia received T-cell-depleted allografts using Campath-1G. Two thirds of the marrow was infused on the scheduled day of transplant and one third of the marrow following preincubation with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-3 (IL-3) on day 4. Engraftment parameters and duration of hospitalization were compared by actuarial analysis to those of 40 historical controls. Patients receiving the incubated boost had significantly faster platelet recovery (P = .017) and shorter hospitalization period (P = .001) when compared with the control subjects. Platelet count reached greater than 25 x 10(9)/L on day 17 (median) in the study group and on day 23 in the controls. The median duration of hospitalization was 20 and 36 days, respectively. In the early posttransplantation follow-up, two of four patients in the study group died as a result of graft rejection, while all 13 deaths in the control group resulted from complications associated with marrow suppression. We suggest that pretransplant in vitro activation of bone marrow cells with IL-3 and GM-CSF may prove to be an efficient method for enhancing marrow recovery after BMT.