A pilot study of the biologic and therapeutic effects of granulocyte colonystimulating factor (filgrastim) in patients with acute myelogenous leukemia

A. Jakubowski, M. Gordon, A. Tafuri, S. Schuster, M. Andreeff, J. H. Shieh, M. Vincent, J. Gabrilove

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4 Scopus citations

Abstract

In a carefully monitored pilot study, the in vivo biologic effects of filgrastim were investigated in eight patients with relapsed/refractory acute myelogenous leukemia. Within each patient, filgrastim was administered as a single agent prior to any chemotherapy in escalating doses of 0.12-6.0 μg/kg/day as a continuous intravenous infusion. The dose was increased every 14 days until an ANC of ≥2500/mm3 had been achieved or there was evidence of proliferation of the leukemia. In patients who demonstrated growth of the leukemic clone, cytosine arabinoside was initiated at 200 mg/m2/day for 5 days. Throughout the course of therapy, the effects of filgrastim on maturation and proliferation were assessed by in vitro studies of bone marrow aspirates. Three patients demonstrated a sustained increase in ANC; one achieved a partial remission and remained on therapy for 31 weeks. Two of the three responding patients had hypocellular marrows at the time of initiating filgrastim and demonstrated a low but normal pattern of growth in CFU-GM assay early in the treatment course. This suggested that these two characteristics may define an environment in which filgrastim can induce a growth advantage for the normal residual hematopoietic elements. In this study of selected patients, filgrastim appeared safe.

Original languageEnglish
Pages (from-to)1799-1804
Number of pages6
JournalLeukemia
Volume9
Issue number11
StatePublished - Nov 1995
Externally publishedYes

Keywords

  • Filgrastim
  • G-CSF
  • Leukemia
  • Maturation

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