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Dr. Shu-quan Ji, from The General Hospital of Air Force PLA in Beijing, China, and colleagues studied 48 leukemia patients who underwent HLA-identical BMT. The donors of 30 patients were given G-CSF prior to marrow harvest, while the donors of the remaining patients were not.
Stimulated bone marrow demonstrated higher numbers of nucleated cells as well as CFU-GM and CD34+ cells, the investigators note. In addition, hematopoietic reconstitution was accelerated when G-CSF-primed bone marrow was employed. Only one patient in the G-CSF-primed transplant group experienced severe acute GVHD compared with five patients in the non-primed group (p = 0.02).
While the groups did not differ in the incidence of chronic GVHD and relapse, there was a trend toward improved disease-free survival in the G-CSF-primed bone marrow group.
G-CSF stimulation was associated with a significant decrease in CD4+ cells and a significant increase in CD8+ cells, the authors report in the October issue of Clinical Transplantation.
The prompt engraftment seen with G-CSF-stimulated marrow was probably due to the increase in CD34+ cells, the researchers suggest. The reduced incidence of severe acute GVHD was probably mediated by G-CSF's effects on T-cell and monocyte cytokine production.
Clin Transplant 2001;15:317-323
Source: Reuters
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