French researchers report that GM-CSF can be used instead ofbone marrow transplant to regenerate the immune cells ofcancer patients receiving intensive, last-ditch chemotherapy.

Three of five patients survived the cytokine therapy and theircancer, recovering their white cells and platelets. At least onepatient's remission has lasted 13 months.

Granulocyte macrophage colony stimulating factor has beenapproved for use in helping marrow grafts to implant andsurvive. The French study, reported this week in The Lancet,suggests that the cytokine alone can reconstitute a patient'smarrow.

Using a prolonged infusion of Behring-Hoechst's recombinanthuman GM-CSF, derived from E. coli, the doctors at Hospital St.Antoine in Paris treated five patients with non-Hodgkin'slymphoma in the end stages of the disease. The patients hadreceived a chemotherapy regimen that usually must befollowed by a bone marrow transplant. Previously harvestedmarrow could not be used because it could not be purged ofcancer cells.

The cytokine helps immature white blood cells to grow anddifferentiate. Presumably, the researchers wrote, some cellssurvive the chemotherapy and are sufficiently stimulated byGM-CSF to replace the entire marrow. The two patients whodid not survive showed that GM-CSF cannot act alone when themarrow is too severely damaged, the researchers wrote.

The only side effects that could be related to the cytokinewere reversible headache and a transient rash in one patient.

The researchers cautioned that the results following thespecific BEAM high-dose chemotherapy regimen could notnecessarily be expected from other regimens.

Immunex Corp. of Seattle and Hoechst-Roussel, a subsidiary ofHoechst AG of Germany, have U.S. approval for their co-developed GM-CSF for accelerating myeloid recovery inpatients with non-Hodgkin's lymphoma, Hodgkin's disease, andacute lymphoblastic leukemia who are receiving their ownbone marrow saved before their chemotherapy.

Genetics Institute Inc. of Cambridge, Mass., in collaborationwith Sandoz/Schering Plough also is developing GM-CSF.

The French authors cited a previous study that suggested thatgranulocyte colony stimulating factor achieved similar resultsin dogs. Amgen Inc. markets G-CSF.

-- Roberta Friedman, Ph.D. Special to BioWorld

(c) 1997 American Health Consultants. All rights reserved.