Lack of effect on platelet increments of granulocyte-macrophage-colony- stimulating factor following autologous bone marrow transplantation for malignant lymphoma

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Abstract
Recombinant growth factors are used increasingly often to stimulate bone marrow recovery after intensive chemotherapy and bone marrow transplantation. Their effects on the requirements for and responsiveness to coincident therapies, including transfusion, should be defined. To determine whether treatment with recombinant granulocyte-macrophage-colony-stimulating factor (GM-CSF) affects platelet transfusion responsiveness, the clinical and blood bank records were examined for 16 adult patients (8 controls, 8 receiving GM-CSF) participating in a double-blind study of GM-CSF administration (250 micrograms/m2 x 21 days) following autologous bone marrow transplantation for lymphoma. For each platelet transfusion, a corrected count increment was calculated, and note was made of the presence or absence of selected additional factors thought to decrease platelet responsiveness: fever, amphotericin treatment, HLA antibodies, platelet ABO incompatibility, and febrile transfusion reactions. The total number of platelet transfusions (GM-CSF patients, 145; controls, 145) and the mean number of transfusions per patient (GM-CSF, 18.3; controls, 18.0) were comparable in the two groups. GM-CSF patients received significantly more platelets that were ABO incompatible, that were given during a febrile period, or that were given while the patient was on amphotericin. Nevertheless, the corrected count increments in patients who received GM-CSF were at least as good as those in controls: for GM-CSF patients: mean was 8,574 +/- 5,868, median was 7,818, 49 percent were < 7,500 and 66 percent were < 10,000; for controls; mean was 7,618 +/- 7,536, median was 6,100, 59 percent were < 7,500, and 73 percent were < 10,000. In this group of patients, GM-CSF did not adversely affect the required number of, increments to, or incidence of refractoriness to platelet transfusions.

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