Jawaid Channa, Khalid Zafar Hashmi.
Role of Recombinant Granulocyte - Macrophage Colony - Stimulating factors in reducing the duration of Neutropenia.
J Coll Physicians Surg Pak Jan ;12(9):538-41.

Objective: To evaluate the role of recombinant Granulocyte-Macrophage Colony-Stimulating Factor (rGM-CSF) in reducing the duration of neutropenia and hospital stay after induction chemotherapy in acute myeloid leukemia (AML). Design: A randomised control trial. Place and Duration of Study: The study was carried out at Liaquat National Postgraduate Medical Center, Karachi from December 1995 to January 1999. Subjects and Methods: Twenty-two newly diagnosed cases of AML, 11 males and 11 females with median age of 27.5 (6-60) years were selected. The induction chemotherapy given was Doxorubicin 45 mg/m2/day intravenous for three consecutive days (day 1-3) and Ara C 100mg/m2/day intravenous infusion for seven consecutive days (day 1-7). Bone marrow aspiration was repeated on day 7 to exclude the presence of residual blast cells. The patients were then randomized to receive rGM-CSF in a dose of 7 micrograms /kg/day subcutaneously (Group-A) or placebo (Group-B). Duration of neutropenia (ANC< 0.5*109/L) and length of hospital stay was recorded. Results: In Group-A, mean duration of neutropenia was 19.3 days which is statistically non-significant (p=<0.05) as compared to Group-B i.e 17.4 days and mean duration of hospital stay was 22.2 days which is also statistically non-significant (p=<0.05) as compared to Group-B i.e 19.6 days. Conclusion: rGM-CSF failed to reduce the duration of neutropenia and hospital stay after induction chemotherapy in AML.

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